Aneurysms of the superficial venous system: classification and treatment

Abstract

Superficial venous aneurysms are rarely described and they may remain indolent or become the source for pulmonary emboli. A system of classification and treatment protocol according to size and location is proposed.Three hundred thirty patients were evaluated for symptomatic venous disease (C2-C6) over a 2-year period. A proposed designation for venous aneurysm is described. Patients fulfilling this criterion are described in reference to site of involvement, histologic findings, and method of treatment. Five percent of patients met the criteria for venous aneurysm. Nine aneurysms of the greater saphenous vein were identified. Three aneurysms were proximal to the subterminal valve and the rest were distal.

Partially thrombosed aneurysm of the medial marginal vein

“…However, many valvular dilatations in the venous system could meet this definition. A more rigorous criterion for venous aneurysmal designation would have included three times the size of the normal vein and twice the size of the contiguous vein …”

“…Venous aneurysms are classified into primary or secondary based on their etiology, and superficial or deep based on their location with respect to the muscular fascia. While secondary venous aneurysms develop as consequences of trauma, inflammation, or venous hypertension, congenital vessel wall weakness is the most commonly suspected etiology of primary venous aneurysms . Compared to their deep counterparts, superficial venous aneurysms have commanded less attention in the literature due to their lower prevalence and less frequent association with thromboembolic events.…”

“…Indications for treatment of superficial venous aneurysms include esthetic considerations and symptoms . Asymptomatic aneurysms are managed depending on their location and risk of becoming a source of pulmonary embolism, and anticoagulation may be necessary if surgical excision, which is the preferable treatment, is not feasible . With regards to medical marginal vein aneurysms, all reported cases have been treated with simple surgical excision without reconstruction …”

“…It was not painful, but More than 90% of lower extremity superficial venous aneurysms involve the great saphenous vein above the knee. 6,7 To our knowledge, five cases of medial marginal vein or dorsal venous arch aneurysm have been described in the English literature, with one being secondary to repetitive trauma. 4 The remaining four cases, similar to the present one, were considered primary, with no eliciting cause.…”

“…10 Asymptomatic aneurysms are managed depending on their location and risk of becoming a source of pulmonary embolism, and anticoagulation may be necessary if surgical excision, which is the preferable treatment, is not feasible. 7 With regards to medical marginal vein aneurysms, all reported cases have been treated with simple surgical excision without reconstruction. [2][3][4][5] In conclusion, awareness of aneurysms of the medial marginal vein of the foot and their imaging characteristics is important since, because of their rarity, they may be misdiagnosed as vascular malformation, ganglion cyst, or soft tissue tumor.…”