Popliteal venous aneurysms

Characteristics, management strategies, and clinical outcomes - A modern single-center series

Cameron W. Donaldson, Rahmi Oklu, Michael T. Watkins, Magruder C. Donaldson, Farhad Abtahian, Robert M. Schainfeld, Michael R. Jaff, Ido Weinberg

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Popliteal vein aneurysm (PVA) may be an incidental finding on imaging, but often presents in the context of acute venous thromboembolism (VTE). The role of anticoagulation with or without surgical excision versus expectant management is ill defined.

Methods In this single-center, retrospective, cohort study, patient records from January 2002 to December 2013 were queried for terminology consistent with PVA. Demographic data and clinical outcomes were extracted via chart review.

Results A total of 21 patients with PVA were identified (57% male). Mean follow-up was 38 ± 31 months. Mean PVA diameter was 2.5 ± 1.1 cm; 67% were saccular (with the remainder being fusiform), 19% contained thrombus, 67% were left sided, and bilateral PVA was present in 24% of cases. At the time of PVA diagnosis, 14% had pulmonary embolism. Treatment consisted of observation only (62%), anticoagulation (19%), surgery (5%), or both anticoagulation and surgery (14%). There were no recurrences of VTE once treated, although there was 1 acute deep venous thrombosis in a patient who was managed conservatively. Two patients had recurrent PVA after surgery, and there were 2 surgical complications (transient foot drop and hematoma).

Conclusions PVA is associated with VTE. Based on our series, it is unclear if incidentally discovered PVA (without VTE) warrants treatment with anticoagulation and/or surgical repair. Further multicenter studies are needed to establish the indications for safety and durability of surgery.

Original languageEnglish (US)
Pages (from-to)1816-1822
Number of pages7
JournalAnnals of Vascular Surgery
Volume28
Issue number8
DOIs
StatePublished - Nov 1 2014
Externally publishedYes

Fingerprint

Popliteal Vein
Aneurysm
Venous Thromboembolism
Incidental Findings
Pulmonary Embolism
Terminology
Venous Thrombosis
Hematoma
Multicenter Studies
Foot
Thrombosis
Cohort Studies
Retrospective Studies
Observation
Demography
Safety

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Medicine(all)

Cite this

Popliteal venous aneurysms : Characteristics, management strategies, and clinical outcomes - A modern single-center series. / Donaldson, Cameron W.; Oklu, Rahmi; Watkins, Michael T.; Donaldson, Magruder C.; Abtahian, Farhad; Schainfeld, Robert M.; Jaff, Michael R.; Weinberg, Ido.

In: Annals of Vascular Surgery, Vol. 28, No. 8, 01.11.2014, p. 1816-1822.

Research output: Contribution to journalArticle

Donaldson, CW, Oklu, R, Watkins, MT, Donaldson, MC, Abtahian, F, Schainfeld, RM, Jaff, MR & Weinberg, I 2014, 'Popliteal venous aneurysms: Characteristics, management strategies, and clinical outcomes - A modern single-center series', Annals of Vascular Surgery, vol. 28, no. 8, pp. 1816-1822. https://doi.org/10.1016/j.avsg.2014.06.065
Donaldson, Cameron W. ; Oklu, Rahmi ; Watkins, Michael T. ; Donaldson, Magruder C. ; Abtahian, Farhad ; Schainfeld, Robert M. ; Jaff, Michael R. ; Weinberg, Ido. / Popliteal venous aneurysms : Characteristics, management strategies, and clinical outcomes - A modern single-center series. In: Annals of Vascular Surgery. 2014 ; Vol. 28, No. 8. pp. 1816-1822.
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N2 - Background Popliteal vein aneurysm (PVA) may be an incidental finding on imaging, but often presents in the context of acute venous thromboembolism (VTE). The role of anticoagulation with or without surgical excision versus expectant management is ill defined.Methods In this single-center, retrospective, cohort study, patient records from January 2002 to December 2013 were queried for terminology consistent with PVA. Demographic data and clinical outcomes were extracted via chart review.Results A total of 21 patients with PVA were identified (57% male). Mean follow-up was 38 ± 31 months. Mean PVA diameter was 2.5 ± 1.1 cm; 67% were saccular (with the remainder being fusiform), 19% contained thrombus, 67% were left sided, and bilateral PVA was present in 24% of cases. At the time of PVA diagnosis, 14% had pulmonary embolism. Treatment consisted of observation only (62%), anticoagulation (19%), surgery (5%), or both anticoagulation and surgery (14%). There were no recurrences of VTE once treated, although there was 1 acute deep venous thrombosis in a patient who was managed conservatively. Two patients had recurrent PVA after surgery, and there were 2 surgical complications (transient foot drop and hematoma).Conclusions PVA is associated with VTE. Based on our series, it is unclear if incidentally discovered PVA (without VTE) warrants treatment with anticoagulation and/or surgical repair. Further multicenter studies are needed to establish the indications for safety and durability of surgery.

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