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Case report
Rare pulmonary embolism caused by the combination of bilateral popliteal venous aneurysms and antiphospholipid syndrome
  1. Tomoki Fukui,
  2. Nobuyuki Ogasawara and
  3. Shinji Hasegawa
  1. Department of Cardiology, Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan
  1. Correspondence to Dr Tomoki Fukui; tomoki.fukui{at}


Popliteal venous aneurysm (PVA) and antiphospholipid syndrome (APS) are under-recognised as potential causes of pulmonary embolism (PE). A 66-year-old woman presented with progressive shortness of breath. A contrast-enhanced CT revealed bilateral PE, a small renal infarction and bilateral PVAs. Direct oral anticoagulant (DOAC) therapy was initiated immediately for venous thrombosis. Given the positivity for serum antiphospholipid antibody (aPL) in an initial blood test, low-dose aspirin was included to prevent further arterial thrombosis. Her symptoms resolved and she was discharged 1 week later. Twelve weeks later, she was diagnosed with APS because of persistent aPL. Surgical resection of the right PVA was performed 1 year later from her hospitalisation. To the best of our knowledge, this is the first case of PE caused by the combination of bilateral PVAs and APS. This report emphasises the importance of careful screening to identify PE causes, and its optimal management.

  • venous thromboembolism
  • vascular surgery
  • cardiovascular system
  • immunology

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  • Contributors The paper was authored by TF; conception and design, and writing the article by NO; and final approval of the article by SH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.