Recurrent popliteal vein aneurysm

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Presentation transcript:

Recurrent popliteal vein aneurysm Antonios P. Gasparis, MD, RVT, Morad Awadallah, MD, Robert J. Meisner, MD, Cheng Lo, MD, Nicos Labropoulos, PHD, DIC, RVT Journal of Vascular Surgery Volume 51, Issue 2, Pages 453-457 (February 2010) DOI: 10.1016/j.jvs.2009.06.065 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 A bulge is seen in the left popliteal fossa at the level of the incision. The patient noticed that the mass increased in size over time. A soft compressible mass was felt in this area on palpation. Journal of Vascular Surgery 2010 51, 453-457DOI: (10.1016/j.jvs.2009.06.065) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 Diagnostic imaging of the left popliteal fossa. A, Magnetic resonance venography (MRV) demonstrating a saccular aneurysm with the medial gastrocnemial vein emptying into the sac. B, B-mode ultrasound showing slow flow in the popliteal vein but no thrombosis. Journal of Vascular Surgery 2010 51, 453-457DOI: (10.1016/j.jvs.2009.06.065) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 Intraoperative images of the aneurysm. A, A saccular aneurysm arises from the near wall of the popliteal vein in relation to the popliteal fossa. The wall of the aneurysm appeared to be inflamed. B, Normal-appearing popliteal vein after the resection of the aneurysm. The suture line at the end-to-end anastomosis is seen in the center of the vein. Journal of Vascular Surgery 2010 51, 453-457DOI: (10.1016/j.jvs.2009.06.065) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 4 Staining of specimens from the aneurysm and the edges of the wall/aneurysm border. A, Elastin staining from the aneurysm shows marked reduction and fragmentation of the elastin lamellae (original magnification ×100). B, Adjacent wall to the aneurysm shows hypertrophy but intact elastic lamellae (original magnification ×100). C, Trichrome staining showing invasion of fibrous tissue in the intima and media layers with reduction in the smooth muscle cells (original magnification ×20). D, Hypertrophy of the adjacent wall with marked fibrous tissue invasion without reduction in the smooth muscle cells (original magnification ×100). Journal of Vascular Surgery 2010 51, 453-457DOI: (10.1016/j.jvs.2009.06.065) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 5 Postoperative duplex ultrasound at 3 months. A, B-mode image showing a normal-caliber popliteal vein, with a postoperative hematoma. B, B-mode image, showing the popliteal vein in long view. The anastomosis is seen in the image. C, Color-mode image demonstrating a normal-caliber popliteal vein without evidence of reflux or thrombosis. Journal of Vascular Surgery 2010 51, 453-457DOI: (10.1016/j.jvs.2009.06.065) Copyright © 2010 Society for Vascular Surgery Terms and Conditions