Venous aneurysms

Abstract

Venous aneurysms are rare lesions that have been described throughout the venous system and are seen at any age. The lower extremities are the most frequently involved, with the popliteal vein being the main location. A wide variety of clinical presentations has been reported in the literature and they can be diagnosed as a subcutaneous mass, a widening mediastinal mass, an incidental finding on an imaging study, or during the workup for abdominal pain or chronic venous disease of the lower limb. Although the natural history of these venous aneurysms is usually benign, depending on their location they have the potential for serious complications and may present initially as an episode of pulmonary embolism, thrombosis, or rupture with bleeding. The management of venous aneurysms still remains controversial, and the indication for surgery should take into consideration the potential for thromboembolic or bleeding complications. Numerous types of surgical repair have been described, and the most common procedures are tangential excision with lateral suture or excision with interposition grafting. Technical choice is usually dictated by the type of aneurysm and by the anatomical location.