Management of Symptomatic Venous Aneurysm

Abstract

Venous aneurysms (VAs) have been described in quite of all the major veins. They represent uncommon events but often life-threatening because of pulmonary or paradoxical embolism. We describe our twelve patients' series with acute pulmonary emboli due to venous aneurysm thrombosis. Our experience underlines the importance of a multilevel case-by-case approach and the immediate venous lower limbs duplex scan evaluation in pulmonary embolism events. Our data confirm that anticoagulant alone is not effective in preventing pulmonary embolism. We believe that all the VAs of the deep venous system of the extremities should be treated with surgery as well as symptomatic superficial venous aneurysm. A simple excision can significantly improve symptoms and prevent pulmonary embolism.

Aneurysms of the superficial venous system: classification and treatment

“…10 A more rigorous criteria would include both vein diameter compared to normal and contiguous vein. Based on histologic studies by the authors of both extrafascial varicose vein segments and those segments meeting the proposed size requirement for a venous aneurysm, the histologic findings are very similar ( Figure 3).…”

Pulmonary Thromboembolism Caused by Prolonged Compression at the Femoral Access Site and a Venous Aneurysm of the Ipsilateral Popliteal Vein

“…2) In this case, who was previously absent of any clinical signs of DVT, a popliteal venous aneurysm might be associated with the occurrence of venous thrombosis. Popliteal venous aneurysms, defined as an isolated dilatation of twice the normal vein diameter, 3) are usually asymptomatic and about 70% of them are first discovered with pulmonary embolism. 4) Under the turbulent flow in an aneurysm, platelets with elevated shear histories and higher incidence of activation were readily deposed to the wall in areas of low wall shear stress, which promote the formation of mural thrombi.…”

Surgical Repair for Popliteal Venous Aneurysm Causing Severe or Recurrent Pulmonary Thromboembolism: Three Case Reports

“…In 55-76% of patients, PVA is associated with chronic venous disease, including superficial vein insuffi ciency, leg swelling, and venous ulceration. 1,5) Rupture is a rare complication of PVA. 5) The etiology of PVA remains unknown, and no association with arterial aneurysm has been reported.…”

“…1,5) Rupture is a rare complication of PVA. 5) The etiology of PVA remains unknown, and no association with arterial aneurysm has been reported.…”

“…7) Anticoagulation therapy alone may not prevent PE in patients with symptomatic PVA, and its sole use as treatment is associated with a high incidence of recurrence. 1,3,5,6,8) Given the potential for serious thromboembolic complications, surgical repair is indicated in all symptomatic patients. However, management of asymptomatic PVA remains a controversial issue.…”