fig.1(new interposed vein graft)
fig.2(aneurysmal sac opened)
fig.3(popliteal artery aneurysm with proximal ectasia)
Popliteal aneurysms are the most common peripheral aneurysms to come across though they are not very common otherwise.Saphenous vein graft getting aneurysmal is all the more rarer though cases are reported wherein the interposed saphenous vein turned aneurysmal.
We present to you an unsual case recently done by us wherein the reversed saphenous vein graft turned aneurysmal with proximal ectasia.
A 70 years old gentleman came to our out patient department with large pulsatile swelling in the popliteal region.He had pain in the leg and was not able to extend his limb at the knee joint.Physical examination revealed large pulsatile mass in the popliteal fossa with a scar on the medial aspect of leg and thigh.History revealed that he was operated upon for popliteal artery aneurysm in 2003 in some hospital by a Vascular surgeon and reversed saphenous vein graft was harvested from the other leg and interposed to replace the aneurysmal segment.He did fine all these years till he noticed the recurrence of swelling that kept increasing slowly and started hurting him.He had only one functioning kidney and the angiogram revealed a large(5cms)popliteal artery aneurysm with ectasia of the proximal vessel.The aneurysm was partially thrombosed as is generally the case with most aneurysms.Popliteal aneurysms though are notorious for even presenting with acute thrombosis leading to limb loss.
Patient was operated successfully with the ectatic/aneurysmal saphenous vein graft replaced by another vein graft.
Its rare to come across aneurysms of the RSVG.Still rarer to come across aneurysm of the vein graft in the popliteal region mimicking a popliteal artery aneurysm.Went through the internet to know more about this but could not come across a single detailed article.
