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采用大隐静脉卷绕移植技术治疗血栓形成的腘静脉动脉瘤

Thrombosed Popliteal Venous Aneurysm Treated With a Great Saphenous Vein Roll Interposition Technique.

作者信息

Sai Yoshun, Sakai Hiroki, Yoshino Kunihiko, Ito Joji

机构信息

Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, JPN.

出版信息

Cureus. 2025 Mar 25;17(3):e81199. doi: 10.7759/cureus.81199. eCollection 2025 Mar.

Abstract

Popliteal venous aneurysms (PVAs) are rare vascular anomalies that can result in serious thromboembolic complications. We present a case of a 77-year-old woman with a thrombosed right PVAs complicated by pulmonary embolism. Following initial anticoagulation, surgical resection of the aneurysm was performed, and individualized venous reconstruction was achieved using an autologous great saphenous vein (GSV) roll graft. This technique was selected over conventional panel or spiral grafts due to its simplicity, adaptability to size discrepancy, and reduced suture lines. To our knowledge, the use of a GSV roll graft, specifically tailored for popliteal vein reconstruction in thrombosed PVAs, has not been previously reported. Postoperative anticoagulation was continued with direct oral anticoagulants. Graft patency was confirmed by duplex ultrasonography and contrast-enhanced CT venography at regular intervals. At 1.5 years post-surgery, graft patency was maintained, and the patient remained symptom-free. This case highlights the effectiveness of individualized venous reconstruction using a GSV roll interposition graft in managing complex thrombosed PVAs.

摘要

腘静脉动脉瘤(PVAs)是罕见的血管异常,可导致严重的血栓栓塞并发症。我们报告一例77岁女性,患有右侧血栓形成的PVAs并伴有肺栓塞。在初始抗凝治疗后,对动脉瘤进行了手术切除,并使用自体大隐静脉(GSV)卷状移植物实现了个体化静脉重建术。由于其操作简单、能适应尺寸差异且减少缝合线,所以选用了该技术而非传统的平板或螺旋状移植物。据我们所知,此前尚未有专门为血栓形成性PVAs的腘静脉重建量身定制的GSV卷状移植物的使用报道。术后继续使用直接口服抗凝剂进行抗凝治疗。定期通过双功超声和对比增强CT静脉造影确认移植物通畅情况。术后1.5年,移植物保持通畅,患者无症状。该病例突出了使用GSV卷状间置移植物进行个体化静脉重建术在处理复杂血栓形成性PVAs方面的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/310d/12022380/f6b91f6658cf/cureus-0017-00000081199-i01.jpg

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