Presentation and management of venous aneurysms

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Presentation transcript:

Presentation and management of venous aneurysms David L. Gillespie, MD, RVT, J.Leonel Villavicencio, MD, Chris Gallagher, MD, Audrey Chang, PhD, John K. Hamelink, MD, Lois A. Fiala, MD, Sean D. O'Donnell, MD, Mark R. Jackson, MD, Emmanouil Pikoulis, MD, Norman M. Rich, MD Journal of Vascular Surgery Volume 26, Issue 5, Pages 845-852 (November 1997) DOI: 10.1016/S0741-5214(97)70099-5 Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Venous aneurysms of the extremities. A, Aneurysm of the forearm that triples the size of the normal venous segment above and below it. B, Large aneurysm of the deep venous system of the calf. Both aneurysms were excised. Journal of Vascular Surgery 1997 26, 845-852DOI: (10.1016/S0741-5214(97)70099-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Venous aneurysms of the extremities. A, Aneurysm of the forearm that triples the size of the normal venous segment above and below it. B, Large aneurysm of the deep venous system of the calf. Both aneurysms were excised. Journal of Vascular Surgery 1997 26, 845-852DOI: (10.1016/S0741-5214(97)70099-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Large venous aneurysm of the calf in a young patient with Klippel-Trenaunay syndrome. These anomalies are frequent in vascular malformations involving the venous system and explain the high incidence of thromboembolism reported in most series. Journal of Vascular Surgery 1997 26, 845-852DOI: (10.1016/S0741-5214(97)70099-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Saccular aneurysms of the superficial femoral vein and a tributary of the profunda femoris. The first was repaired by tangential excision and lateral venorrhaphy, and the latter was excised. B, Postoperative phlebography illustrates patency of the repair. Recovery was uneventful. Journal of Vascular Surgery 1997 26, 845-852DOI: (10.1016/S0741-5214(97)70099-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Saccular aneurysms of the superficial femoral vein and a tributary of the profunda femoris. The first was repaired by tangential excision and lateral venorrhaphy, and the latter was excised. B, Postoperative phlebography illustrates patency of the repair. Recovery was uneventful. Journal of Vascular Surgery 1997 26, 845-852DOI: (10.1016/S0741-5214(97)70099-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 A, Ascending phlebogram in a 9-year-old girl with Klippel-Trenaunay syndrome shows a double popliteal venous aneurysm. B, Through a “Z” incision at the popliteal space, the aneurysm was excised. Venous outflow of the extremity was ensured through a large “vena marginalis.” There was no postoperative edema. Journal of Vascular Surgery 1997 26, 845-852DOI: (10.1016/S0741-5214(97)70099-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 A, Ascending phlebogram in a 9-year-old girl with Klippel-Trenaunay syndrome shows a double popliteal venous aneurysm. B, Through a “Z” incision at the popliteal space, the aneurysm was excised. Venous outflow of the extremity was ensured through a large “vena marginalis.” There was no postoperative edema. Journal of Vascular Surgery 1997 26, 845-852DOI: (10.1016/S0741-5214(97)70099-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Under Valsalva maneuver, aneurysms of the internal jugular vein may become alarmingly large (right panel). However, their course is usually benign, and surgical excision is rarely indicated. Journal of Vascular Surgery 1997 26, 845-852DOI: (10.1016/S0741-5214(97)70099-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Under Valsalva maneuver, aneurysms of the internal jugular vein may become alarmingly large (right panel). However, their course is usually benign, and surgical excision is rarely indicated. Journal of Vascular Surgery 1997 26, 845-852DOI: (10.1016/S0741-5214(97)70099-5) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions