From the Research
Popliteal vein aneurysms should be treated with surgical intervention, specifically closed plication, for symptomatic or large aneurysms (>2 cm), as it has been shown to have favorable primary patency rates and low recurrence rates, as demonstrated in the most recent study by 1.
Key Points
- Popliteal vein aneurysms are rare vascular abnormalities characterized by localized dilatations of the popliteal vein, typically defined as an increase in diameter of at least twice the normal size.
- Treatment depends on the size, symptoms, and presence of complications, with surgical intervention being the standard approach for symptomatic or large aneurysms.
- For symptomatic or large aneurysms (>2 cm), surgical repair is recommended, typically through closed plication, as it has been shown to have fewer complications compared to other methods, such as tangential aneurysmectomy with lateral venorrhaphy or resection with end-to-end anastomosis or interposition grafting using autologous vein, as reported by 1.
- Asymptomatic small aneurysms may be managed conservatively with regular ultrasound surveillance every 6-12 months and anticoagulation therapy, such as warfarin with target INR 2-3, or direct oral anticoagulants like rivaroxaban 20 mg daily, to prevent thromboembolic complications.
- Endovascular approaches using stent grafts are emerging alternatives in select cases.
- Prompt treatment is essential as these aneurysms carry significant risk of pulmonary embolism (up to 70% at presentation) and other thromboembolic complications, as highlighted by 2 and 3.
- Following surgical repair, patients typically require anticoagulation for at least 3-6 months and should undergo regular follow-up with duplex ultrasound to monitor for recurrence or development of new aneurysms, as recommended by 4 and 5.