Samuel C. Aldridge, MD, Anthony J. Comerota, MD, Mira L

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Presentation transcript:

Popliteal venous aneurysm: Report of two cases and review of the world literature Samuel C. Aldridge, MD, Anthony J. Comerota, MD, Mira L. Katz, MLA, RVT, John H. Wolk, MD, Bruce I. Goldman, MD, John V. White, MD Journal of Vascular Surgery Volume 18, Issue 4, Pages 708-715 (October 1993) DOI: 10.1016/0741-5214(93)90081-V Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 A, Duplex image of popliteal venous aneurysm with intraluminal thrombus. B, Ascending phlcbogram confirming popliteal venous aneurysm with intraluminal thrombus. C, Resected venous aneurysm sac with intraluminal thrombus. Note appearance of acute, jellylike thrombus despite therapeutic anticoagulation. Journal of Vascular Surgery 1993 18, 708-715DOI: (10.1016/0741-5214(93)90081-V) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Microscopic appearance of aneurysm wall in case 1. A, Intima (i) is thickened (between open arrows) with hyalinized superficial zone and hypercellular deeper zone containing prominent vascular channels (solid arrows). Fascicles of medial smooth muscle (m) are also seen between intima and adventitia (a). Fragment of recent thrombus (t) is present in lumen. (Hematoxylin-eosin stain; original magnification × 80.) B, Elastic tissue stain shows multiple reduplications of internal elastic lamina (open arrows). Vascular channels (solid arrows) are also evident within intima. Medial smooth muscle is not apparent in this section. (Verhoeff's and van Gieson's stain; original magnification × 80.) Journal of Vascular Surgery 1993 18, 708-715DOI: (10.1016/0741-5214(93)90081-V) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Ascending phlebogram of popliteal venous aneurysm. B, Duplex image of popliteal venous aneurysm with no intraluminal thrombus. C, Ascending phlebogram 3 months after tangential aneurysmectomy and lateral venorrhaphy. Journal of Vascular Surgery 1993 18, 708-715DOI: (10.1016/0741-5214(93)90081-V) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Microscopic appearance of aneurysm wall in case 2. A, Apparent intima (i) shows fibrocellular thickening (open arrows) without vascular proliferation. Between intima and adventitia (a) is zone of dense fibrosis (solid arrows). No medial smooth muscle is present. (Hematoxylin-eosin stain; original magnification × 80.) B, Elastic tissue stain shows no internal elastic lamina. A few elastic fibers (solid arrows) are present in adventitia. (Verhoeff's and van Gieson's stains; original magnification × 80.) Journal of Vascular Surgery 1993 18, 708-715DOI: (10.1016/0741-5214(93)90081-V) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 A, Illustration of technique of tangential aneurysmectomy with lateral venorrhaphy. Clamp is placed at base of aneurysm without compromising lumen of popliteal vein. Vein walls are approximated by undersewing clamp with running horizontal mattress stitch. B, Aneurysm is resected flush with vascular clamp. C, Second, reinforcing running stitch is placed, approximating vein wall edges external to mattress suture. Journal of Vascular Surgery 1993 18, 708-715DOI: (10.1016/0741-5214(93)90081-V) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions