Klinische Bedeutung und Therapie venöser Aneurysmen der unteren Extremitäten

Abstract

Isolated venous aneurysms are very rare. In clinical practice it is predominantly seen in the course of a random diagnosis to find the cause of pulmonary embolism or venous thrombosis. Due to an increased use of duplex scans there is also an increase in the number of diagnoses of venous aneurysms even if patients are still asymptomatic. The precise prevalence is yet unknown. The choice of therapeutic procedure is dependent on each individual clinic as well as the size and morphology (fusiform or saccular) of the aneurysm. At present, the available data are still insufficient. We discuss our own surgical treatment of 7 patients with primary aneurysms involving the vena cava, iliac vein, great saphenous vein junction and popliteal vein in consideration of the latest literature.

Rapidly Growing and Ruptured Great Saphenous Vein Aneurysm in a Liver Transplant Patient

“…Among different complications, such as thrombosis or compression of adjacent structures, spontaneous ruptures are the most infrequent; however, they represent a severe and potentially life-threatening complication that necessitates urgent surgical intervention. In contrast to arterial aneurysms, where ruptures are a relatively common complication, there are not many reported cases of ruptured venous aneurysms, which makes our case an unique and interesting clinical scenario [3,5]. In our case, the rupture occurred only about 2 weeks after the initial diagnosis and prompted urgent surgical treatment.…”

“…The cause of venous aneurysms is often attributed to trauma, inflammation, infection, venous insufficiency, or hypertension, but many cases remain idiopathic. Spontaneous venous aneurysms can also occur in congenital vascular syndromes, such as Klippel-Trenaunay syndrome [1,3,7].…”

“…Various surgical approaches for aneurysm removal include ligation, tangential excision with lateral venorrhaphy or autologous vein patch, and complete resection with end-to-end anastomosis or interposition grafting [1,5]. Alternative therapies, such as endovenous laser or radiofrequency ablation, have also been described, but they lack long-term success data [3,23].…”

“…Depending on the anatomical position of the main venous structure, venous aneurysms of extremities can be classified as either superficial or deep. The exact pathophysiology of their formation is unclear, and several different mechanisms have been suggested [2,3]. Clinical presentation varies, with many cases being asymptomatic and incidentally discovered through imaging.…”