Untreated Superior Vena Cava Aneurysm: Radiological Significance and Review of the Literature

Abstract

Superior vena cava (SVC) aneurysms are a rare entity. The majority of the literature is in the form of case reports. SVC aneurysms are often an incidental finding with iatrogenic, congenital, or idiopathic etiologies. Treatment goals focus on preventing theoretical rupture or thrombus formation. Management options include observation, conservative medical management, surgical excision, and thrombin injection. We present a 73-year-old female with an incidental SVC aneurysm discovered on computed tomography (CT) of the thorax. The patient was observed without intervention for greater than 6 years. No complications were attributable to the SVC aneurysm during follow-up or over the course of the patient's life.

Clinics in diagnostic imaging (194)

“…(4) This is especially so for fusiform aneurysms that have lower complication rates. (5) Thrombolytic therapy with recombinant tissue plasminogen activator was deemed to be harmful in one case, in which mobilisation of the thrombus in the SVC aneurysm resulted in recurrent pulmonary embolism. (3) Surgical resection, usually through a median sternotomy approach, has been advocated for saccular aneurysms due to risks of complications, (1) and for aneurysms that are larger than 40 mm, growing or symptomatic, or those that contain thrombi.…”

A Rare Case of Superior Vena Cava Saccular Aneurysm

“…The exact mechanism by which these aneurysms form has not been elucidated, but suggested theories include congenital abnormalities, inflammation, infection, mechanical trauma, and pathologic deficiencies of the SVC longitudinal muscle wall adventia. [3][4][5] An association with cystic hygromas has been suggested because of the similar embryologic origins of the venous and lymphatic systems. 3 Often, the exact etiology of SVC aneurysms cannot be confirmed.…”

“…[3][4][5] An association with cystic hygromas has been suggested because of the similar embryologic origins of the venous and lymphatic systems. 3 Often, the exact etiology of SVC aneurysms cannot be confirmed.…”

“…Thus, aspirin therapy has been recommended as the anticoagulant modality of choice for reduction of thrombotic events in patients without evidence of thrombus formation. 3,6 When thrombus is present, the treatment plan should reflect standardized protocol, weighing risks and benefits concerning the initiation of anticoagulation. Our patient developed a symptomatic pulmonary embolism, so we chose apixaban for further clot prevention, with a good result.…”

Congenital superior caval vein aneurysm in a newborn with cystic lymphangioma: a rare case report

“…In the absence of other associated abnormalities, it was diagnosed as idiopathic dilatation of the superior caval vein. 1,2 At 30 weeks of gestation, the maximum dilatation was measured to be 8.1 mm, and the cardiac anatomy was normal. After a normal pregnancy, labour and vaginal delivery occurred without complications, and a 2.750-kg full-term female infant was born.…”