PMC10421578_01
Thoracic computed tomography angiography (A) axial and (B) sagittal demonstrating pulmonary embolism (arrow).
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A thoracic computed tomography angiography (CTA) was performed (Figure 1) and the patient was diagnosed with acute PE and was immediately treated with systemic thrombolysis in an outside facility (40 milligrams of Tenecteplase) and anticoagulation (apixaban 5 milligrams BID) without complications or bleeding.
Lower limb computed tomography (a) coronal and (b) sagittal showing 3 x 3-centimeter dilatation of the popliteal vein (arrow).
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During workup to rule out deep vein thrombosis (DVT), a fusiform dilation of the left popliteal vein measuring 3 by 3 centimeters (cm) and with an incomplete filling defect was detected on computed tomography of the lower limb, and the patient was referred to the vascular surgery service at our institution (Figure 2).
Posterior view of the popliteal fossa showing the popliteal vein aneurysm.
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Surgery was performed under general anesthesia with the patient in a prone position, a posterior popliteal approach was used with a lazy S incision, and the popliteal vein was dissected and controlled with vascular loops (Figure 3).
One-month follow-up popliteal duplex ultrasound evaluation in color doppler demonstrating patency (A) of the surgically reconstructed popliteal vein without aneurysmal dilation or presence of thrombus (B).
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On the follow-up visit at 1 year, the patient was asymptomatic, and an ultrasound found complete patency of the popliteal vein (Figure 4).