A 48-year old man presented with left popliteal pain. A 2.2×1.6 cm sized saccular aneurysm at the level of the left popliteal fossa was diagnosed by ultrasonography. Tangential aneurysmectomy and popliteal vein repair was performed uneventfully. The patient fared well for a year without symptoms. Popliteal vein aneurysms are rare and typically found in patients with fatal thromboembolic features without warning symptoms. Fortunately, our patient had localized pain which was helpful in its early diagnosis and treatment.
Aneurysm* ; Early Diagnosis ; Humans ; Popliteal Vein* ; Ultrasonography

PURPOSE: The lessor saphenous vein is an anatomical index in various surgical methods involving an approach to the popliteal fossa. However, occasionally, there have been some cases where the surgical process was difficult because the lessor saphenous vein was not found in the popliteal fossa during the operation process. The aim of this study is to determine the frequency of the anatomical variation of lessor saphenous vein not found in the popliteal fossa with a review of the literature. MATERIALS AND METHODS: This study was conducted on 83 cases of selective neurectomy for hypertrophic calf performed in our clinic from March 1997 to June 2013. There were 42 patients, with a mean age of 32.8 years old. We confirmed the existence of the lessor saphenous vein in the popliteal fossa during the operation process. RESULTS: Among 83 cases during this study period, the lesser saphenous vein was not found in four cases. In one patient, no lesser saphenous vein was found on either side of the popliteal fossa, and in two patients, no lesser saphenous vein was found on the left side of the popliteal fossa. As a result, the frequency of variation was found to be 4.8%. CONCLUSION: Due to the anatomical variation of the lessor saphenous vein, it may not be found in the midline of the popliteal fossa. Based on the literature review, several possibilities for failure to observe the lesser saphenous vein could be suggested. If surgeons are well aware of these possibilities, the steadier operation could be performed.
Anatomic Variation ; Humans ; Methods ; Popliteal Vein ; Saphenous Vein*

Although a popliteal cyst is most commonly identified as an asymptomatic mass occurring just below the popliteal fossa, the fluid may further extravasate into a deep compartment, causing compression with symptoms of local pain and tenderness. When the popliteal vein is compressed by a popliteal cyst, it may develop the symptom simulating the deep vein thrombosis, when the popliteal artery is compressed, it may develop the symptom simulating the ischemic pain and intermittent claudication. It is unusual for popliteal cysts to involve a nerve. When such does occur, it usually involves the tibial nerve, very rarely the peroneal nerve. It is important to diagnose a popliteal cyst early and to differentiate it from a ganglionic cyst, thrombophlebitis or a popliteal aneurysm, to effect optimal therapy and to obviate a potential neuropathy. We are now reporting a case of a thirty four-year-old male who had a popliteal cyst causing tibial nerve compression.
Aneurysm ; Ganglion Cysts ; Humans ; Intermittent Claudication ; Male ; Peroneal Nerve ; Popliteal Artery ; Popliteal Cyst* ; Popliteal Vein ; Thrombophlebitis ; Tibial Nerve* ; Venous Thrombosis

Infected vascular lesion, including aortic graft infection, is one of the most challenging fields in vascular surgery. The primary treatment objectives are to remove the infected graft material and to re-establish vascular continuity with an extra-anatomic bypass or in situ graft replacement. Despite significant progress in perioperative care and antimicrobial therapy, mortality and morbidity remain high. The great saphenous veins are gaining wide popularity as acceptable native vascular grafts, but in terms of flow capacity, their small caliber may be unsuitable for immediate replacement of arterial flow. Superficial femoral popliteal vein grafts are excellent conduits for infected aortic, peripheral arterial and central venous lesion, in terms of feasible harvesting, resistance to infection, serving immediate high postoperative flow and long-term durability. Surgery using the superficial femoral vein (SFV) graft is neither time-consuming nor dangerous. A delicate preoperative and intraoperative surgical plan is mandatory, and future studies regarding the long-term patency, appropriate clinical indication and safety issue of the SFV graft in peripheral vessel reconstruction are warranted.
Femoral Vein ; Glycosaminoglycans ; Perioperative Care ; Popliteal Vein ; Saphenous Vein ; Transplants ; Veins

Popliteal artery entrapment syndrome is an infrequent disease that usually occurs in relatively young patients. The authors encountered a case of unilateral popliteal artery occlusion caused by anomalous slippage of the medial head of the gastrocnemius muscle. Complete resection of the occluded segment and myotomy of the anomalous slip were performed, and end-to-end re-anastomosis was completed using a saphenous vein graft. At 18 months after the procedure, there was no evidence of recurrence.
Head ; Humans ; Knee ; Muscle, Skeletal ; Popliteal Artery ; Saphenous Vein ; Transplants

Adventitial cystic disease (ACD) is a rare, but well-characterized vascular disease. It is most commonly seen in the popliteal artery, but it has also been reported in the venous system. The most commonly involved segment has been the common femoral vein; the disease resulted in luminal compromise and extremity swelling. We report here on a case of adventitial cystic disease of the left external iliac vein that was initially misdiagnosed as deep vein thrombosis in a 68-year-old man who presented with a painless swelling of his left leg.
Aged ; Extremities ; Femoral Vein ; Humans ; Iliac Vein* ; Leg ; Phenobarbital ; Popliteal Artery ; Vascular Diseases ; Venous Thrombosis

PURPOSE: To assess the CT findings of acute deep venous thrombosis (DVT) in a lower extremity prior to catheter-directed thrombolysis, and to evaluate their relevance to the patency of an iliac venous stent placed with the help of CT after catheter-directed thrombolysis of DVT. MATERIALS AND METHODS: Fourteen patients [M:F=3:11; age, 33-68 (mean, 50.1) years] with acute symptomatic DVD of a lower extremity underwent CT before and after catheter-directed thrombolysis using an iliac venous stent. The mean duration of clinical symptoms was 5.0 (range, 1-14 days. The CT findings prior to thrombolysis were evaluated in terms of their anatomic cause and the extent of the thrombus, and in all patients, the patency of the iliac venous stent was assessed at CT performed during a follow-up period lasting 6-31 (mean, 18.9) months. RESULTS: All patients were assigned to the patent stent group (n=9) or the occluded stent group (n=5). In the former, the anatomic cause of patency included typical iliac vein compression (May-Thurner syndrome) (n=9), and a relatively short segmental thrombus occurring between the common iliac and the popliteal vein (n=8). Thrombi occurred in the iliac vein (n=3), between the common iliac and the femoral vein (n=3), and between the common iliac and the popliteal vein (n=2). In one case, a relatively long segmental thrombus occurred between the common iliac vein and the calf vein. In the occluded stent group, anatomic causes included atypical iliac vein compression (n=3) and a relatively long segmental thrombus between the common iliac and the calf vein (n=4). Typical iliac vein compression (May-Thurner syndrome) occurred in two cases, and a relatively short segmental thrombus between the external iliac and the common femoral vein in one. CONCLUSION: Factors which can affect the patency of an iliac venous stent positioned affer catheter-directed thrombolysis are the anatomic cause of the stenosis, and the extent of a thronbus revealed at CT of acute DVT and occurring in a lower extremity prior to thrombolysis.
Constriction, Pathologic* ; Femoral Vein ; Follow-Up Studies ; Humans ; Iliac Vein* ; Lower Extremity* ; Popliteal Vein ; Stents* ; Thrombosis* ; Veins ; Venous Thrombosis*

PURPOSE: The aim of this study is to evaluate how much influence iliac vein compression exerts on the clinical feature of deep venous thrombosis (DVT). METHODS: One hundred five cases of lower extremity DVT were enrolled. The cases were grouped by location of the thrombus, left/right and inferior vena cava, iliac vein (IV), femoral vein (FV), popliteal vein, and calf vein. The estimated frequency was calculated by means of that the numbers of each goup were divided by the group's mean of DVT risk score. The minor distance from the right iliac artery to the fifth lumbar vertebral body overlying the left iliac vein was measured in computed tomography. Correlation of the severity and the minor distance was evaluated. RESULTS: Left, right, and bilateral DVT were represented in 66, 26, and 13 cases, respectively. Estimated frequencies were 2, 6.47, 5.47, 2.08, and 0.96 in the left side and 2, 1.44, 2.5, 1.33, and 1 in the right, respectively. Statistics significance was seen at the IV and FV levels. The means of minor distances in millimeters were 4.88, 3.98, 6.13, 6.20, and 4.20 in the left and 2.50, 7.00, 5.20, 7.33, and 6.50 in the right, respectively. Significance was seen only at the IV level. DVT severity and the minor distance could not be correlated with statistical significance. CONCLUSION: We consider that May-Thurner's anatomical changes impacts the DVT prevalence only at the proximal vein. We also suggest that the compression of the left iliac vein might be a contributing factor for developing DVT but not for severity of the DVT.
Femoral Vein ; Iliac Artery ; Iliac Vein ; Lower Extremity ; Popliteal Vein ; Prevalence ; Spine ; Thrombosis ; Veins ; Vena Cava, Inferior ; Venous Thrombosis

PURPOSE: To analyze the causes, clinical features, and computed tomography (CT) images of atypical varicose veins in the popliteal fossa unrelated to small saphenous vein (SSV) reflux by three-dimensional CT venography (3D-CTV). METHODS: A total of 1,476 limbs in 794 consecutive patients with varicose veins who underwent surgery from 2005 to 2009 were enrolled. The medical records, duplex ultrasound, and 3D-CTV images were analyzed retrospectively. RESULTS: Varicose veins in the popliteal fossa (PFV) were found in 438 of 1,476 limbs; the PFV in 428 limbs (97.5%) were caused by SSV insufficiency. Ten limbs (2.5%) had atypical PFV unrelated to the SSV. Incompetent perforator of the PPF was found in six of ten limbs (four women and two men; median age, 58-years). The CEAP clinical classes were C2 in four limbs and C4 in two limbs. The PPF drained to the popliteal vein in five limbs and to the gastrocnemial vein in one limb. A perforator ligation was performed in all patients, and additional sclerotherapy was performed in one patient. Thigh or calf perforator insufficiency was found in three limbs (two women and one man; median age, 62.7-years). The CEAP clinical classes were C2 in two limbs and C3 in one limb. Great saphenous vein insufficiency with Giacomini vein reflux was found in one limb (woman, 67-years). CONCLUSION: An exact preoperative understanding of the anatomy and flow dynamics is essential for the proper treatment of rare atypical PFV. A preoperative evaluation with 3D-CTV can provide accurate anatomical information for the surgery.
Extremities ; Female ; Humans ; Ligation ; Medical Records ; Phlebography ; Popliteal Vein ; Retrospective Studies ; Saphenous Vein ; Sclerotherapy ; Thigh ; Varicose Veins ; Veins

Edema ; pathology ; Humans ; Ischemia ; pathology ; Leg ; blood supply ; Ligation ; Male ; Popliteal Vein ; abnormalities ; pathology ; surgery ; Saphenous Vein ; pathology