International Vein Congress May 12-14, 2011 DISCLOSURE David L. Walrath, M.D., F.A.C.S., A.B.Ph., R.P.V.I I have no financial relationships to disclose.

Venous Aneurysms at the SFJ David L. Walrath, M.D., F.A.C.S., A.B.Ph., R.P.V.I Vein Center of Lake Norman Huntersville, NC

Venous Aneurysms at the SFJ RGSVPre-operative year old female

Venous Aneurysms at the SFJ RGSV 2 weeks post operative year old female

Venous Aneurysms at the SFJ RGSV 2 months post operative year old female

Venous Aneurysms at the SFJ Definition: A vein aneurysm is defined as an isolated zone of venous dilatation that communicates with a normal sized venous segment not associated with trauma or varicose Definition: A vein aneurysm is defined as an isolated zone of venous dilatation that communicates with a normal sized venous segment not associated with trauma or varicose veins. (1.5 x nl) veins. (1.5 x nl)

Venous Aneurysms at the SFJ Histology: Histology: The walls are thinner, all three layers are present, but there is loss of small muscle and elastic fibers with an increase in fibrous connective tissue. The walls are thinner, all three layers are present, but there is loss of small muscle and elastic fibers with an increase in fibrous connective tissue.

Venous Aneurysms at the SFJ Superficial venous aneurysms can cause DVT and rarely pulmonary emboli especially if near the SFJ. Superficial venous aneurysms can cause DVT and rarely pulmonary emboli especially if near the SFJ.

Venous Aneurysms at the SFJ However, we also know that a groin incision is responsible for neovascularization and that neovascularization significantly increase the rate of recurrence. However, we also know that a groin incision is responsible for neovascularization and that neovascularization significantly increase the rate of recurrence.

Venous Aneurysms at the SFJ In a recent phlebology article Dr. Ferreira stated that the International Endovenous laser working group (I.E.W.G.) does not recommend simultaneous crossectomy (ligation) in patients treated with EVLT except in cases of associated pathologies such as venous aneurysms. In a recent phlebology article Dr. Ferreira stated that the International Endovenous laser working group (I.E.W.G.) does not recommend simultaneous crossectomy (ligation) in patients treated with EVLT except in cases of associated pathologies such as venous aneurysms.

Venous Aneurysms at the SFJ I welcome your advice!

Venous Aneurysms at the SFJ Thank you!