462-75 |Pedunculated Thrombus in a Left Popliteal Artery Aneurysm Which Resolved on Anticoagulation Therapy-Pedunculated Thrombus in a Left Popliteal Artery Aneurysm Which Resolved on Anticoagulation Therapy

Pedunculated Thrombus in a Left Popliteal Artery Aneurysm Which Resolved on Anticoagulation Therapy

Pdf Summary

This case report describes an unusual finding of a "floating" or pedunculated thrombus within a left popliteal artery aneurysm (PAA), which completely resolved after 10 days of anticoagulation therapy. The patient, a 69-year-old man with multiple arterial aneurysms and associated vascular interventions, presented for routine surveillance of his PAAs using duplex ultrasound. A pedunculated thrombus extending into the left tibioperoneal trunk artery was detected. The patient had a history of major vascular interventions, including an open repair of an abdominal aortic aneurysm and treatment for various other aneurysms. Duplex ultrasound, using the Philips EPIQ Ultrasound machine, was performed to assess the popliteal arteries. Peak systolic velocities were measured using color and spectral Doppler. The patient underwent heparin therapy followed by oral administration of apixaban. On day 11, a repeat ultrasound showed complete resolution of the thrombus. PAAs are the most common type of peripheral artery aneurysms and can be asymptomatic or present with symptoms such as claudication or distal ischemia. This case highlights the effectiveness of anticoagulation therapy in resolving a thrombus within a PAA and the importance of surveillance using duplex ultrasound. Treatment options for PAAs include open surgical bypass grafting and endovascular repair with a synthetic stent graft. The choice of treatment depends on various factors, including the patient's fitness for surgery and the availability of suitable vein conduits. This case report contributes to the limited literature on "floating" thrombus within a PAA and provides valuable insights into the management of this condition.

Keywords

floating thrombus

pedunculated thrombus

left popliteal artery aneurysm

anticoagulation therapy

duplex ultrasound

tibioperoneal trunk artery

vascular interventions

peak systolic velocities

heparin therapy

apixaban