Recidiverende longembolieën bij aneurysma V. poplitea

Background

Popliteal venous aneurysms are very rare, but when left untreated they can lead to severe and recurrent pulmonary embolism.

Case description

A 35-year-old man was referred to the outpatients’ vascular clinic for additional diagnostics of a swelling just above the back of his right knee. He had a history of recurrent idiopathic pulmonary embolism despite anticoagulation. Diagnostic imaging revealed a large popliteal venous aneurysm. The patient underwent surgical resection of the aneurysm and was prescribed oral anticoagulation postoperatively. Duplex ultrasound at 3 months postoperative revealed unimpeded blood flow in the venous interposition graft. The patient no longer had oedema.

Conclusion

Aneurysms of the popliteal vein should be included in the differential diagnosis of patients with pulmonary embolism. In patients with unexplained recurrent pulmonary embolism despite anticoagulation, additional diagnostic imaging of the lower extremities should be considered and inclusion of duplex ultrasound is recommended.

Conflict of interest and financial support: none declared.