ORIGINAL ARTICLE   

Acta Phlebologica 2022 April;23(1):24-7

DOI: 10.23736/S1593-232X.22.00521-5

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Venous aneurysm… does it differ? Twenty-five years of experience in Egypt

Ayman M. FAKHRY ¹ ✉, Sohiel A. NAGIB ²

¹ Egyptian Military Academy, Alexandria, Egypt; ² Alexandria Armed Forces Hospital, Alexandria, Egypt

BACKGROUND: Venous aneurysm is uncommon condition and can be defined as a persistent isolated dilatation of twice the normal vein diameter. In contrast to arterial aneurysms, clear recommendations for management are not well defined. Our aim was to review the presentations of venous aneurysms, available imaging modalities for defining them, and management techniques to isolate these aneurysms and restore the vein continuity.
METHODS: In a retrospective cohort study, we reported and analyzed 13 patients with venous aneurysms admitted to Alexandria armed Forces hospital representing our experience over 25 years from 1995-2020 in different sited of their bodies.
RESULTS: Age ranged from 15 to 67 years with a mean age 22.7±1.06 years and a little female dominance and female to male ratio was 8/5. Primary venous aneurysm was detected in 11 patients (85%), while secondary venous aneurysm was shown only in two patients (15%). Conservative treatment for two patients (15%) with full anticoagulation and follow-up, while surgical isolation with tangential aneurysmectomy and regain the continuity of the vein in saccular aneurysms in seven patients (52.5%), and surgical excision of the aneurysm and interposition graft in two patients (15%).
CONCLUSIONS: Venous aneurysms are uncommon, and their presentation ranges from asymptomatic, to life-threatening PE or rupture with bleeding. Despite the prevalence of endovascular techniques in modern vascular surgery practice, there is no defined role for them in the management of venous aneurysms, and open surgical repair remains the “gold standard,” either ligation or excision tangential aneurysmectomy with lateral venorrhaphy.

KEY WORDS: Aneurysm; Duplex Doppler ultrasonograpy; Operative surgical procedures; Venous thrombosis