Incidence and Prevention of Deep Vein Thrombosis in Patients with Popliteal Vein Aneurysm

Abstract

Introduction: Venous popliteal aneurysms are associated with high risk for deep vein thrombosis (DVT) and pulmonary embolism (PE). The goal of this study was to report the incidence and prevention options of DVT in patients with popliteal vein aneurysm. Methods: All patients between 06/1993 and 03/2019 with diagnosed popliteal venous aneurysm were enrolled in this study and analyzed retrospectively. Data were collected prospectively in an institutional database (M1, CompuGroup Medical) throughout the observation period by trained staff. The patients related variables were documented in a standardized manner. They received regular surveillance alone or treatment. Patients were offered aneurysm resection or lifelong anticoagulation if they had aneurysm size twice of normal vein diameter. Compression stockings were recommended in all cases. Clinical exam and duplex ultrasound were performed 3-6 months after operation or primary diagnosis and annually thereafter. In case of incompliance of wearing compression stockings, patients received instructions of the importance of compression and help for dressing them. Results: In a total of 58 patients 60 popliteal vein aneurysms (aneurysm size mean 20.3 mm) were diagnosed. Two patients had popliteal vein aneurysm on both legs (mean 1.5 mm). 33 patients had aneurysm size >20 mm in diameter. They had a significantly higher incidence of turbulent flow in duplex sonographic examination with higher risk for development of DVT (7/33; p=.006). Out of them, 30/33 (91%) preferred aneurysm resection, while 3/33 (9%) patients were treated with lifelong anticoagulation and compression. Patients with aneurysm size < 20 mm were treated with compression stockings alone. No DVT occured after treatment or in patients with small popliteal vein aneurysm size. Mean follow up was 39.5±8.7 months. Conclusion: Patients with large popliteal venous aneurysms experience DVT more frequently. Therefore, popliteal vein aneurysms >20 mm should be considered for surgical treatment or lifelong anticoagulation, depending on patient's preference. In patients with small aneurysm size regular control and compression stockings in risk situations are adequate. Disclosure: Nothing to disclose