Surgical treatment of popliteal venous aneurysms

Jill K. Johnstone, Mark D. Fleming, Peter Gloviczki, William Stone, Manju Kalra, Gustavo Oderich, Audra A. Duncan, Randall R De Martino, Thomas C. Bower

Research output: Contribution to journalArticle

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Abstract

Background Popliteal venous aneurysms (PVAs) are rare; however, they can lead to pulmonary emboli (PEs) and death. The purpose of this study was to review our institutional management of PVA. Methods All patients with PVA undergoing intervention in our institution were identified over a 15-year period (1998-2013). A retrospective review including clinical presentation, modality of diagnosis, surgical treatment, 30-day morbidity and mortality, and follow-up are reported. Results Five male and 3 female patients with PVA were identified. Mean age was 38.6 years (range, 14-65). Five patients presented with PE; 1 developed PE while on anticoagulation. Two presented with lower extremity pain. Two patients had PVA found incidentally. Diagnosis of PVA was made by duplex ultrasound (US) in 6 patients, physical examination confirmed with duplex US in 1 patient, and magnetic resonance imaging in 1 patient. Mean aneurysm size was 26 mm (range, 20-37). Four were saccular and 4 fusiform. Three PVAs contained thrombus, including 2 patients presenting with PE and 1 with calf pain. Five patients underwent aneurysmectomy with lateral venorrhaphy, and 3 patients had resection of the aneurysm with interposition vein graft. There were no operative or 30-day mortalities. Two patients with vein grafts had early postoperative complications; one developed a hematoma that required operative evacuation and one had thrombosis of the vein graft requiring thrombolysis. Mean follow-up was 26 months with 87.5% primary patency, 100% secondary patency, and no recurrences. Conclusions PVAs are rare, but can lead to significant morbidity and death. Based on this small group, aneurysmectomy with lateral venorrhaphy appears to have fewer complications compared with those treated with vein grafts. Overall, operative repair of PVA is safe and recommended in select patients with PVA.

Original languageEnglish (US)
Pages (from-to)1084-1089
Number of pages6
JournalAnnals of Vascular Surgery
Volume29
Issue number6
DOIs
StatePublished - Aug 1 2015

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Aneurysm
Embolism
Veins
Therapeutics
Transplants
Lung
Thrombosis
Morbidity
Pain
Mortality
Hematoma
Physical Examination
Lower Extremity
Magnetic Resonance Imaging
Recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Johnstone, J. K., Fleming, M. D., Gloviczki, P., Stone, W., Kalra, M., Oderich, G., ... Bower, T. C. (2015). Surgical treatment of popliteal venous aneurysms. Annals of Vascular Surgery, 29(6), 1084-1089. https://doi.org/10.1016/j.avsg.2015.02.009

Surgical treatment of popliteal venous aneurysms. / Johnstone, Jill K.; Fleming, Mark D.; Gloviczki, Peter; Stone, William; Kalra, Manju; Oderich, Gustavo; Duncan, Audra A.; De Martino, Randall R; Bower, Thomas C.

In: Annals of Vascular Surgery, Vol. 29, No. 6, 01.08.2015, p. 1084-1089.

Research output: Contribution to journalArticle

Johnstone, JK, Fleming, MD, Gloviczki, P, Stone, W, Kalra, M, Oderich, G, Duncan, AA, De Martino, RR & Bower, TC 2015, 'Surgical treatment of popliteal venous aneurysms', Annals of Vascular Surgery, vol. 29, no. 6, pp. 1084-1089. https://doi.org/10.1016/j.avsg.2015.02.009
Johnstone JK, Fleming MD, Gloviczki P, Stone W, Kalra M, Oderich G et al. Surgical treatment of popliteal venous aneurysms. Annals of Vascular Surgery. 2015 Aug 1;29(6):1084-1089. https://doi.org/10.1016/j.avsg.2015.02.009
Johnstone, Jill K. ; Fleming, Mark D. ; Gloviczki, Peter ; Stone, William ; Kalra, Manju ; Oderich, Gustavo ; Duncan, Audra A. ; De Martino, Randall R ; Bower, Thomas C. / Surgical treatment of popliteal venous aneurysms. In: Annals of Vascular Surgery. 2015 ; Vol. 29, No. 6. pp. 1084-1089.
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abstract = "Background Popliteal venous aneurysms (PVAs) are rare; however, they can lead to pulmonary emboli (PEs) and death. The purpose of this study was to review our institutional management of PVA. Methods All patients with PVA undergoing intervention in our institution were identified over a 15-year period (1998-2013). A retrospective review including clinical presentation, modality of diagnosis, surgical treatment, 30-day morbidity and mortality, and follow-up are reported. Results Five male and 3 female patients with PVA were identified. Mean age was 38.6 years (range, 14-65). Five patients presented with PE; 1 developed PE while on anticoagulation. Two presented with lower extremity pain. Two patients had PVA found incidentally. Diagnosis of PVA was made by duplex ultrasound (US) in 6 patients, physical examination confirmed with duplex US in 1 patient, and magnetic resonance imaging in 1 patient. Mean aneurysm size was 26 mm (range, 20-37). Four were saccular and 4 fusiform. Three PVAs contained thrombus, including 2 patients presenting with PE and 1 with calf pain. Five patients underwent aneurysmectomy with lateral venorrhaphy, and 3 patients had resection of the aneurysm with interposition vein graft. There were no operative or 30-day mortalities. Two patients with vein grafts had early postoperative complications; one developed a hematoma that required operative evacuation and one had thrombosis of the vein graft requiring thrombolysis. Mean follow-up was 26 months with 87.5{\%} primary patency, 100{\%} secondary patency, and no recurrences. Conclusions PVAs are rare, but can lead to significant morbidity and death. Based on this small group, aneurysmectomy with lateral venorrhaphy appears to have fewer complications compared with those treated with vein grafts. Overall, operative repair of PVA is safe and recommended in select patients with PVA.",
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AU - Duncan, Audra A.

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N2 - Background Popliteal venous aneurysms (PVAs) are rare; however, they can lead to pulmonary emboli (PEs) and death. The purpose of this study was to review our institutional management of PVA. Methods All patients with PVA undergoing intervention in our institution were identified over a 15-year period (1998-2013). A retrospective review including clinical presentation, modality of diagnosis, surgical treatment, 30-day morbidity and mortality, and follow-up are reported. Results Five male and 3 female patients with PVA were identified. Mean age was 38.6 years (range, 14-65). Five patients presented with PE; 1 developed PE while on anticoagulation. Two presented with lower extremity pain. Two patients had PVA found incidentally. Diagnosis of PVA was made by duplex ultrasound (US) in 6 patients, physical examination confirmed with duplex US in 1 patient, and magnetic resonance imaging in 1 patient. Mean aneurysm size was 26 mm (range, 20-37). Four were saccular and 4 fusiform. Three PVAs contained thrombus, including 2 patients presenting with PE and 1 with calf pain. Five patients underwent aneurysmectomy with lateral venorrhaphy, and 3 patients had resection of the aneurysm with interposition vein graft. There were no operative or 30-day mortalities. Two patients with vein grafts had early postoperative complications; one developed a hematoma that required operative evacuation and one had thrombosis of the vein graft requiring thrombolysis. Mean follow-up was 26 months with 87.5% primary patency, 100% secondary patency, and no recurrences. Conclusions PVAs are rare, but can lead to significant morbidity and death. Based on this small group, aneurysmectomy with lateral venorrhaphy appears to have fewer complications compared with those treated with vein grafts. Overall, operative repair of PVA is safe and recommended in select patients with PVA.

AB - Background Popliteal venous aneurysms (PVAs) are rare; however, they can lead to pulmonary emboli (PEs) and death. The purpose of this study was to review our institutional management of PVA. Methods All patients with PVA undergoing intervention in our institution were identified over a 15-year period (1998-2013). A retrospective review including clinical presentation, modality of diagnosis, surgical treatment, 30-day morbidity and mortality, and follow-up are reported. Results Five male and 3 female patients with PVA were identified. Mean age was 38.6 years (range, 14-65). Five patients presented with PE; 1 developed PE while on anticoagulation. Two presented with lower extremity pain. Two patients had PVA found incidentally. Diagnosis of PVA was made by duplex ultrasound (US) in 6 patients, physical examination confirmed with duplex US in 1 patient, and magnetic resonance imaging in 1 patient. Mean aneurysm size was 26 mm (range, 20-37). Four were saccular and 4 fusiform. Three PVAs contained thrombus, including 2 patients presenting with PE and 1 with calf pain. Five patients underwent aneurysmectomy with lateral venorrhaphy, and 3 patients had resection of the aneurysm with interposition vein graft. There were no operative or 30-day mortalities. Two patients with vein grafts had early postoperative complications; one developed a hematoma that required operative evacuation and one had thrombosis of the vein graft requiring thrombolysis. Mean follow-up was 26 months with 87.5% primary patency, 100% secondary patency, and no recurrences. Conclusions PVAs are rare, but can lead to significant morbidity and death. Based on this small group, aneurysmectomy with lateral venorrhaphy appears to have fewer complications compared with those treated with vein grafts. Overall, operative repair of PVA is safe and recommended in select patients with PVA.

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