Popliteal Venous Aneurysm as a Cause of Ankle Pain

Abstract

Popliteal venous aneurysms (PVAs) are rare and in most cases the primary presentation includes pulmonary thromboembolism and post-thrombotic syndrome. Although few cases of PVA with pain in the popliteal fossa were reported, no previous case of PVA-related an ankle pain is known. We describe the case of a 70-year-old woman presenting with PVA-related ankle pain. Computed tomography revealed a 25×23 mm venous aneurysm of the distal popliteal vein. During surgery, the tibial nerve was found to be compressed between PVA and the gastrocnemius muscle. PVA was resected with a venous aneurysm of the small saphenous vein, which was 10 mm in diameter. The continuity of the deep venous system was restored upon transposition of the small saphenous vein. The pain in the right ankle resolved postoperatively, the patient received anticoagulation therapy and was treated with compression stockings. Venography was performed 54 months after surgery, which revealed a patent popliteal vein without any evidence of stenosis. This report shows that ankle pain can present as a symptom of a venous aneurysm in the distal popliteal vein.