Aneurysma der V. poplitea als Ursache multipler Lungenembolien

VASA ◽  
2003 ◽  
Vol 32 (4) ◽  
pp. 221-224 ◽  
Author(s):  
Sigg ◽  
Koella ◽  
Stöbe ◽  
Jeanneret
Keyword(s):  
Pulmonary Embolism ◽  
Vena Cava ◽  
Young Patients ◽  
Left Knee ◽  
Popliteal Vein ◽  
High Rate ◽  
Venous Aneurysm ◽  
Pulmonary Emboli ◽  
Duplex Imaging ◽  
Lung Scan

Generally, most aneurysms of the venous system are probably congenital and rarely have clinical significance. Popliteal aneurysms are an exception of this rule and are known to be a source of recurrent pulmonary emboli. We present a previously healthy 42 year old man with multiple pulmonary emboli, diagnosed with a high probability lung scan. Venous duplex imaging and magnet resonance imaging showed a mass with connection to the popliteal vein of the left knee, suggesting a venous aneurysm. Despite therapeutic anticoagulation he suffered further pulmonary emboli. After insertion of a temporary vena cava inferior filter aneurysm resection and patch reconstruction of the popliteal vein was performed. By duplex imaging we proved the patency of the popliteal vein after surgical repair. Popliteal venous aneurysms should be kept in mind as possible thromboembolic source in young patients with pulmonary embolism. Our review of the current literature about popliteal venous aneurysms revealed a high rate of pulmonary embolism.

Pulmonary emboli due to venous aneurysm of extremities

VASA ◽  
2011 ◽  
Vol 40 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Gabrielli ◽  
Rosati ◽  
Vitale ◽  
Millarelli ◽  
Siani ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Surgical Resection ◽  
Potential Risk ◽  
Acute Pulmonary Embolism ◽  
Prophylactic Surgery ◽  
Venous Aneurysm ◽  
Pulmonary Emboli ◽  
Thromboembolic Events ◽  
Thromboembolic Complications ◽  
Risk Patients

Venous aneurysms are uncommon but they can have devastating consequences, including pulmonary embolism, other thromboembolic events and death. We report six cases of venous aneurysm of the extremities, in which the first sign of presence was acute pulmonary embolism. Surgical resection is recommended whenever possible. Our experience suggests that prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for extremity deep and superficial venous aneurysms for their potential risk of developing thromboembolic complications despite adequate anticoagulation. Other venous aneurysms should be excised only if they are symptomatic or enlarging.

A Comparative Analysis of D-Dimer Assays in Patients with Clinically Suspected Pulmonary Embolism

1993 ◽  
Vol 70 (03) ◽  
pp. 408-413 ◽  
Author(s):  
Edwin J R van Beek ◽  
Bram van den Ende ◽  
René J Berckmans ◽  
Yvonne T van der Heide ◽  
Dees P M Brandjes ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Comparative Analysis ◽  
High Probability ◽  
Pulmonary Emboli ◽  
Plasma Samples ◽  
Suspected Pulmonary Embolism ◽  
Lung Scan ◽  
D Dimer

SummaryTo avoid angiography in patients with clinically suspected pulmonary embolism and non-diagnostic lung scan results, the use of D-dimer has been advocated. We assessed plasma samples of 151 consecutive patients with clinically suspected pulmonary embolism. Lung scan results were: normal (43), high probability (48) and non-diagnostic (60; angiography performed in 43; 12 pulmonary emboli). Reproducibility, cut-off values, specificity, and percentage of patients in whom angiography could be avoided (with sensitivity 100%) were determined for two latex and four ELISA assays.The latex methods (cut-off 500 μg/1) agreed with corresponding ELISA tests in 83% (15% normal latex, abnormal ELISA) and 81% (7% normal latex, abnormal ELISA). ELISA methods showed considerable within- (2–17%) and between-assay Variation (12–26%). Cut-off values were 25 μg/l (Behring), 50 μg/l (Agen), 300 μg/l (Stago) and 550 μg/l (Organon). Specificity was 14–38%; in 4–15% of patients angiography could be avoided.We conclude that latex D-dimer assays appear not useful, whereas ELISA methods may be of limited value in the exclusion of pulmonary embolism.

Primary Venous Aneurysms of the Popliteal Fossa

1993 ◽  
Vol 8 (2) ◽  
pp. 82-85 ◽  
Author(s):  
T. R. Cheatle ◽  
M. Perrin
Keyword(s):  
Pulmonary Embolism ◽  
Outcome Measures ◽  
Surgical Repair ◽  
Postoperative Recovery ◽  
Popliteal Fossa ◽  
Venous Aneurysm ◽  
Pulmonary Emboli ◽  
Radiological Evidence

Objective: To report five cases of primary venous aneurysm arising in the popliteal fossa. Setting: Unite de Pathologie Vasculaire Jean Kunlin, Clinique du Grand-Large, av. Leon-Blum, Decines Charpieu, France. Patients: Five patients with radiological evidence of venous aneurysm in the popliteal fossa. Interventions: Surgical repair in all cases. Main outcome measures: Avoidance of pulmonary embolism. Results: Satisfactory postoperative recovery in all. No complications or subsequent pulmonary emboli.

Therapie der tiefen Venenthrombose mit niedermolekularem Heparin, Beinkompression und sofortigem Gehen

VASA ◽  
2001 ◽  
Vol 30 (3) ◽  
pp. 195-204 ◽  
Author(s):  
H. Partsch
Keyword(s):  
Pulmonary Embolism ◽  
Bed Rest ◽  
Lower Leg ◽  
Bleeding Complications ◽  
Pulmonary Emboli ◽  
Malignant Diseases ◽  
Vein Thrombosis ◽  
Fatal Bleeding ◽  
Lung Scan ◽  
Low Incidence

Background: Traditionally, patients with acute deep vein thrombosis (DVT) are treated with strict bed rest for several days to avoid clots from breaking off and causing pulmonary emboli. The purpose of this study is to give a precise estimate of short term complications like pulmonary embolism, bleeding, heparin-induced thrombocytopenia (HIT) and death in a cohort of consecutive patients who were admitted because of acute symptomatic DVT, all treated by compression and walking exercises instead of conventional bed-rest and nearly all by low-molecular-weight heparin. Patients and methods: In 1289 consecutive patients the following five endpoints were registered for the period of hospital-stay: 1. Frequency of pulmonary embolism (PE ) at admission (V/Q lung scan), 2. Frequency of new PE’s after 10 days (second lung scan), 3. Fatal events (autopsy), 4. Frequency of malignant disease, 5. Bleeding complications and HIT. Results: 1. 190/356 (53.4% of iliofemoral, 355/675 (52.6%) of femoral and 84/239 (35.1%) of lower leg vein thrombosis showed PE (difference iliofemoral and femoral versus lower leg DVT p < 0.001). Two thirds of these PE were asymptomatic. 2. New PE after 10 days in comparison to the baseline scan occurred in 7.4%, 6.4% and 3.4% respectively. 3. Fatal events, all investigated by autopsy, were caused by PE in 3 patients aged over 76 years (0.23%), by malignant diseases in 12 (0.9%) and due to other causes in 2 (0.15%). 4. 232 patients (18%) had associated malignant diseases, from which 33% were detected by our screening. 5. Non-fatal bleeding complications were seen in 3.3%, including 5 patients (0.4%) with major bleeding. Three patients (0,2%) suffered from HIT II. Conclusion: The low incidence of recurrent and fatal pulmonary emboli in this series affirms the value of early ambulation with heavy leg compression in patients with symptomatic acute leg deep venous thrombosis. In addition, the presence of pulmonary emboli in one-third of those with calf vein thrombi emphasizes the importance of fully diagnosing and treating calf clots.

scholarly journals P230 Pulmonary embolism due to hepatocellular carcinoma: A rare presentation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Hassan Abdelnabi ◽  
Y Saleh ◽  
A Almaghraby ◽  
O Tok ◽  
H Shehata ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Cardiac Involvement ◽  
Malignant Tumors ◽  
Vena Cava ◽  
High Rate ◽  
Contrast Study ◽  
Rare Presentation ◽  
Tumor Thrombi

Abstract Introduction Hepatocellular carcinoma (HCC) is one of the most common malignant tumors and the second leading cause of cancer-related deaths. HCC is a highly progressive cancer with a high rate of metastasis. Intra-cardiac involvement with HCC is quite rare with a very poor prognosis. Acute pulmonary embolism is a very rare presentation of hepatocellular carcinoma (HCC) complicated with tumor thrombi into the inferior vena cava (IVC), right atrium (RA) and right ventricle (RV) with very poor reported prognosis. Case presentation A 72-years old hepatitis C virus (HCV) positive male patient for 20 years but he didn’t receive any treatment. He was admitted at our medical faculty with decompensated liver failure and resolved hepatic encephalopathy. He started complaining of acute onset of dyspnea. On clinical examination, he was tachypneic, tachycardic with thready pulse, distressed with deep icteric tinge. He had a massive ascites and bilateral lower limb pitting oedema. His electrocardiogram (ECG) showed sinus tachycardia. Urgent transthoracic echocardiography (TTE) revealed a large solid mass extending through the IVC to RA (Figure 1 Panel A) with another highly mobile cauliflower mass at the RV apex occupying the RV cavity, protruding into RA through TV and nearly obliterating RVOT into pulmonary artery. (Figure 1 Panel B, C, D). Due to patient’s frailty and hazards of contrast medium in an already impaired renal status of him, no further contrast study was performed. Only conservative and supportive measures were initiated for the management of his deteriorated general condition but unfortunately, he passed away shortly after. Conclusion Cardiac involvement in HCC rarely occurs and usually develops in advanced stages of HCC. The main mechanism of metastasis into the cardiac cavity is through a direct vascular extension of the tumor to the right side via hepatic vein and IVC. Acute pulmonary embolism in the setting of HCC is a quite rare manifestation of HCC that usually occur due to tumor thrombi in the IVC, RA and RV. The reported prognosis of HCC with intra-cardiac involvement is very poor, with a mean survival of 1 to 4 months at the time of diagnosis. Abstract P230 Figure. TTE of HCC invading RVOT

Complications Post Inferior Vena Cava Filter Placement

2018 ◽  
Vol 42 (1) ◽  
pp. 23-25
Author(s):  
Anita Altawan ◽  
David Golchian ◽  
Bipinchandra Patel ◽  
John Iljas ◽  
Kimia Sohrabi
Keyword(s):  
Pulmonary Embolism ◽  
Rare Complication ◽  
Color Doppler ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Doppler Imaging ◽  
Filter Placement ◽  
Vena Cava Filters ◽  
Duplex Imaging ◽  
Management Of Complications

Duplex and color Doppler imaging have proved to be an excellent noninvasive modality for evaluating complications of percutaneous interventional vascular procedures. Complications including hematoma, pseudoaneurysm, arteriovenous fistula (AVF), thrombosis, stenosis, and vessel occlusion are routinely diagnosed with duplex imaging. The most common complication of vena cava filter placement is bleeding and access site thrombosis. AVF is a rare complication of vena cava filters. Puncture-related AVFs are false vascular channels between an adjacent vein and artery that demonstrate low-resistance arterial signals, high velocity venous outflow, and variable flow patterns within themselves. Vena cava filter placement is a relatively low-risk alternative for prophylaxis against pulmonary embolism in patients with deep vein thrombosis who are not suitable for anticoagulation. There is an increasing trend in the number of vena cava filter implantation procedures performed each year. Vena cava filters are effective in preventing pulmonary embolism but have risks associated with implantation. Awareness of potential complications can lead to early detection as well as management of complications to improve clinical outcomes.

scholarly journals Management of Symptomatic Venous Aneurysm

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Roberto Gabrielli ◽  
Maria Sofia Rosati ◽  
Andrea Siani ◽  
Luigi Irace
Keyword(s):  
Pulmonary Embolism ◽  
Paradoxical Embolism ◽  
Lower Limbs ◽  
Venous Aneurysm ◽  
Pulmonary Emboli ◽  
Duplex Scan ◽  
Deep Venous System ◽  
Simple Excision ◽  
Life Threatening ◽  
Aneurysm Thrombosis

Venous aneurysms (VAs) have been described in quite of all the major veins. They represent uncommon events but often life-threatening because of pulmonary or paradoxical embolism. We describe our twelve patients’ series with acute pulmonary emboli due to venous aneurysm thrombosis. Our experience underlines the importance of a multilevel case-by-case approach and the immediate venous lower limbs duplex scan evaluation in pulmonary embolism events. Our data confirm that anticoagulant alone is not effective in preventing pulmonary embolism. We believe that all the VAs of the deep venous system of the extremities should be treated with surgery as well as symptomatic superficial venous aneurysm. A simple excision can significantly improve symptoms and prevent pulmonary embolism.

Recurrent pulmonary embolism secondary to popliteal vein aneurysm with intraluminal wall ulcer

2012 ◽  
Vol 28 (4) ◽  
pp. 219-222 ◽  
Author(s):  
R Dallatana ◽  
I Barbetta ◽  
A Settembrini ◽  
F Casazza ◽  
R Boeri ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Surgical Treatment ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Popliteal Vein ◽  
Venous Aneurysm ◽  
Ulcerative Lesion ◽  
Recurrent Pulmonary Embolism ◽  
Frequent Site ◽  
Tangential Resection

The popliteal vein is the most frequent site of venous aneurysm. Surgical treatment is indicated above a 2.5 cm diameter to prevent complications, notably deep venous thrombosis and pulmonary embolism (PE). Here we report a case of recurrent episodes of severe PE, leading to cardio-circulatory shock caused by a popliteal vein aneurysm (PVA) despite oral anticoagulant therapy. When surgical correction of the aneurysm was performed, we found an ulcerative lesion in the inner aspect of the vein that was acting as a ‘thrombogenic focus’ inside the aneurysm. An accurate inspection of the intimal wall is always important during surgery of PVA, particularly when tangential resection is performed.

A giant aneurysm of the popliteal vein

VASA ◽  
2012 ◽  
Vol 41 (3) ◽  
pp. 229-232 ◽  
Author(s):  
M. van der Voort ◽  
R. De Maeseneer
Keyword(s):  
Pulmonary Embolism ◽  
Giant Aneurysm ◽  
Popliteal Vein ◽  
Venous Aneurysm ◽  
Recurrent Pulmonary Embolism ◽  
Rare Diagnosis ◽  
Fatal Evolution

Popliteal vein aneurysm is a rare diagnosis, associated with a 70 % risk of pulmonary embolism, sometimes even with fatal evolution. Surgery dramatically reduces the risk of pulmonary embolism. We report a case of a 66-year-old man with recurrent pulmonary embolism and a giant popliteal venous aneurysm (9.3 × 4 × 4 cm) presenting at our dermatological clinic.

Management of symptomatic deep venous thrombosis and pulmonary embolism on a neurosurgical service

1986 ◽  
Vol 64 (4) ◽  
pp. 563-567 ◽  
Author(s):  
Karl W. Swann ◽  
Peter McL. Black ◽  
Mary F. Baker
Keyword(s):  
Pulmonary Embolism ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Anticoagulation Therapy ◽  
Vena Cava ◽  
Pulmonary Emboli ◽  
Content Type ◽  
Neurosurgical Patients ◽  
Fine Print

✓ The authors present a retrospective analysis of the management of deep vein thrombosis (DVT) and pulmonary embolism (PE) in neurosurgical patients at the Massachusetts General Hospital from January, 1978, through June, 1982. There were 44 cases of DVT and 13 cases of PE. Management modalities included observation only, femoral vein ligation, inferior vena cava clipping, transvenous placement of an inferior vena cava filter or umbrella, and anticoagulation therapy. Six (75%) of eight patients with symptomatic DVT who were managed by observation alone had subsequent pulmonary emboli, and three (38%) died. Femoral vein ligation was followed by PE in one of four cases and led to significant leg swelling in two others. Neither observation alone nor femoral vein ligation can be recommended as routine management options. Partial inferior vena cava interruption with a De Weese clip, Kim-Ray Greenfield filter, or Mobin-Uddin umbrella all successfully prevented pulmonary emboli. The major problem associated with these methods was leg edema, which occurred in 47% of patients with clip placement, 25% with filter placement, and 21% with a Mobin-Uddin umbrella. Anticoagulation therapy was associated with a complication rate of 29% and a mortality rate of 15%. Fatal PE and paradoxical hypercoagulability with gangrene of a lower extremity were the causes of death. In one patient, hemorrhage into a glioblastoma occurred following discontinuation of anticoagulation therapy when the coagulation parameters were normal. The authors conclude that: 1) management with observation alone of patients with symptomatic DVT places the patient at risk for the development of life-threatening pulmonary emboli; 2) the safety and timing of therapeutic anticoagulation in postoperative neurosurgical patients or patients with tumors is unclear; and 3) partial interruption of the inferior vena cava with a transvenous filter successfully prevents PE and may represent a safer alternative to anticoagulation therapy.

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