Popliteal Venous Aneurysm as a Cause of Recurrent Pulmonary Embolism

Abstract

We report 2 cases of recurrent pulmonary embolism (PE) in popliteal venous aneurysm (PVA). Patients were 78-year-old and 72-year-old women. Both were initially seen for acute PE. Saccular and fusiform PVAs were diagnosed in each patient based on duplex ultrasound. However, despite anticoagulation therapy, both patients had PE. At the time of the event, 1 patient was receiving inadequate dose of low-molecular-weight heparin. The other patient was treated with warfarin and had adequate international normalized ratio at the time of re-embolism, and thus, an inferior vena cava filter was inserted. Both patients underwent successful aneurysm resection without any additional thromboembolic events.

Popliteal vein aneurysm: Is it necessary to apply anticoagulants after a surgery?

“…In one case, where pulmonary embolism was the first sign of venous disease, oral anticoagulation was prescribed for 6 months (18). Patients who were prescribed long-term anticoagulation had experienced thromboembolic events prior to PVA diagnosis (21,23,28). In 3 cases it was not possible to determine the duration of treatment (17,19,24).…”

“…Among patients who had experienced PE, in five cases temporary vena cava filters were placed prior to surgery as secondary PE prevention (18)(19)(20)(21)28). In one of those cases it was decided to keep the filter in place in the long term (21).…”

“…In one of those cases it was decided to keep the filter in place in the long term (21). Three patients had developed PE at the time of PVA diagnosis despite oral anticoagulation (21,25,28).…”