Management of primary venous aneurysms

OBJECTIVE: Venous aneurysms are a relatively rare abnormality. Unlike arterial aneurysms, venous aneurysms are a much less frequent abnormality. The purpose of our study was to review our experience in the management of venous aneurysms.

METHODS: Nine patients with venous aneurysms, who had undergone operation in the Department of Cardiovascular Surgery, Yuzuncu Yil University Medical School, Van, Turkey, during the period September 1997 through to May 2003, were included in this study. There were 5 female and 4 male patients, ranging in age from 16-47-years with a mean age of 31 +/- 7 years. They were diagnosed by color flow duplex imaging. Eight patients had saccular aneurysm; the remaining one patient with basilar vein aneurysm, had fusiform aneurysm.

RESULTS: Aneurysms were located the lower extremities in 4 cases, the upper extremity in 4, and external jugular vein in one. Aneurysms size ranged from 2, 3 to 5, 5 cm (mean 3, 6 cm). There were no symptoms in 2 patients (cephalic vein aneurysm in one patient, short saphenous vein aneurysm in one). These patients were operated on for cosmetic purposes. Six patients complained of pain associated with a subcutaneous swelling. The remaining one patient with popliteal vein aneurysm complained of extremity pain, associated with deep venous thrombosis. All patients underwent surgery under local anesthesia. In 7 patients, aneurysms were resected and venous continuity with a graft was found unnecessary. End to end anastomosis was performed in 2 patients (popliteal vein aneurysm in one and axillary vein aneurysm in one). During follow up period, there were no recurrences.

CONCLUSION: Venous aneurysms may cause thrombophlebitis, thrombus formation, pulmonary embolism and theoretical complication of spontaneous rupture. Varicose veins, hemangiomas, lymphocele, hernias, hygromas, arteriovenous fistulas and similar subcutaneous swellings located subcutaneous venous spaces should be considered in the differential diagnosis. Consequently, we suggest that surgical treatment be performed to prevent subsequent complications in all cases.