An overview of treatment options for a rare disease, aneurysm of the popliteal vein, in connection with a case

Introduction: Popliteal vein aneurysm is a rare, but potentially life-threatening condition that can lead to deep vein thrombosis and/or pulmonary embolism. It is often asymptomatic, but symptoms may include pain, post -thrombotic syndrome or chronic venous insufficiency. An experienced physician may be able to detect a palpable mass in the popliteal fossa. Duplex ultrasound is the first line of diagnosis. CT or MR venography play a role in the diagnosis. Objective: To review the international literature, explain the possible treatment options, and present our case. Case report: A 62-year-old female patient had a recurrent pulmonary embolism while on direct-acting oral anticoagulant therapy. Duplex ultrasound and MR angiography were performed and confirmed a partially thrombosed aneurysm of the right popliteal vein. Aneurysm resection and venorrhaphy were performed as treatment. At followup, ultrasound showed adequate flow in the deep venous system. 6 months later, the control MR angiography showed good flow without stenosis. There were no postoperative complications. Discussion and literature review: The pathomechanism of the disease remains unclear. Treatment options are con-servative therapy and/or surgical intervention, but there is no consensus regarding the therapy of symptomatic or asymptomatic cases. There is no clear statement regarding the method and duration of postoperative anticoagulant therapy. Conclusion: In the case of recurrent pulmonary embolism, the possibility of a popliteal vein aneurysm should be considered. Ultrasound is a non-invasive, widely available initial diagnostic tool. In addition to conservative treat-ment, the possibility of surgical intervention can be considered. The surgical procedure described in our case was successful.