Primary tibial vein aneurysm with recurrent pulmonary emboli

Abstract

We report the case of a 42-year-old man with pleuritic chest pain, shortness of breath, and associated tachycardia. Three months before, he had been treated for similar features with the diagnosis of pulmonary emboli. Computed tomography scan showed multiple bilateral pulmonary emboli. He had no clinical evidence of deep venous thrombosis, but an accurate venous duplex examination revealed a thrombosis of the posterior tibial vein aneurysm. Thrombolysis, a temporary inferior cava filter (ICV filter), and tangential aneurysmectomy and lateral venorrhaphy were performed. Accurate duplex scan evaluation of lower limb venous system is mandatory in all cases of pulmonary embolism; anticoagulation may be ineffective in preventing pulmonary embolism, and the surgical repair is treatment of choice of this pathology because it is safe and effective.

Management of Symptomatic Venous Aneurysm

“…Pulmonary emboli with severe hemodynamic instability may require thrombolytic therapy to improve cardiopulmonary function and to reduce thrombus burden in the deep venous system before the aneurysm has repair [17]. …”

Posterior Tibial Vein Aneurysm: Case Report

“…Ocasionalmente, um AV superficial pode estar associado a fenômenos tromboembólicos, mas sua real estimativa é ainda desconhecida 4 . Não há concordância na literatura a respeito da localização mais frequente dos aneurismas venosos.…”

“…Aneurismas venosos isolados são raros e geralmente aparecem como achados incidentais no exame físico ou em exames de imagem, sendo ainda pouco descritos na literatura médica, podendo, entretanto, ser lembrados como uma rara causa de embolia pulmonar (EP) e de trombose venosa profunda (TVP) 3 . O aneurisma primário da veia tibial posterior é entidade clínica extremamente rara, tendo sido descritos apenas quatro casos na literatura, todos relacionados com complicações 1,[4][5][6] . O objetivo deste estudo é relatar um caso de aneurisma de veia tibial posterior assintomático, com conduta conservadora.…”

Completely Thrombosed Venous Aneurysm in Great Saphenous Vein

“…Our case is the first case which occurred in a great saphenous vein. Of these six cases, only one case was diagnosed precisely by accurate venous ultrasound imaging and CT scanning3, however the other five cases were misdiagnosed as a soft tissue tumor and so on, in spite of various imaging studies1,2,4,5.…”