Popliteal vein aneurysms are a rare vascular condition that can determine severe complications as pulmonary embolism. We report 2 cases of 56 and 33-years old women, respectively, affected by a saccular popliteal vein aneurysm. Duplex scan and angiography computed tomography have been essential for a correct diagnosis and planning of both treatments. At first, the patients were subjected to anticoagulant therapy with low-molecular-weight heparin (LMWH) pending completion of the pre-operative investigations. The patients were treated surgically with tangential aneurysmectomy with lateral venorrhaphy. Follow-up at 1 and 3 months revealed normal patency of the femoro-popliteal vein axis. Neither sensory nor motor deficit were observed. Popliteal vein aneurysms are rare but have been investigated, especially in case of recurrent thrombo-embolism events. The treatment is only surgical and can be easily approached by prone positions according to the surgeon experience.

Venous flow normally circulates from the skin to superficial veins, which drain into the deep veins and the heart. Venous reflux refers to blood flow that flows in the opposite direction. Venous reflux is caused by gravity and valvular insufficiency. Diagnosing venous reflux is important to determine treatment for lower extremity venous disease. Unlike arteries, venous reflux is greatly affected by the relative position of the probe and the vessel. Standardized ultrasound images are required to verify venous reflux using ultrasound. It is important to perform the reflux provocation test using the standardized posture and method.