Asymptomatic popliteal vein aneurysms

Popliteal vein aneurysms represent a rare vein abnormality. There is agreement on the etiology, symptomatology (thromboembolism), and diagnosis (color duplex scanning). Surgery is the treatment of choice in symptomatic cases, but management in asymptomatic cases remains uncertain. Seven cases (5 women and 2 men with a mean age of fifty-nine years) of asymptomatic popliteal vein aneurysms are presented. The diagnosis and follow-up were made by color flow duplex imaging (CFDI). All aneurysm were of a saccular type, fully compressible, without evidence of thrombus in the sac, and with a maximal diameter ranging from 2.0 to 2.8 cm. In all but 1 case the popliteal valve was located in the aneurysmal sac and minor reflux was detected. Superficial vein incompetence was found in 6 patients, whereas in the seventh patient reflux was found in the superficial femoral vein. No treatment was offered and close surveillance with CFDI every four months was performed. So far, all patients remain asymptomatic over a period of two months to two years. Asymptomatic cases may remain without treatment under close surveillance with CFDI and regular clinical follow-up.