Contemporary management of lower extremity venous aneurysms
| Autor: | Donald T. Baril, Karen Woo, Stefan Hanish, Peter F. Lawrence, Rhusheet Patel |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Time Factors Chronic venous insufficiency Postoperative hematoma 030204 cardiovascular system & hematology Veins 03 medical and health sciences 0302 clinical medicine Aneurysm Postoperative Complications Risk Factors Popliteal vein medicine Humans Superficial thrombophlebitis 030212 general & internal medicine Retrospective Studies business.industry Perioperative Middle Aged medicine.disease Pulmonary embolism Surgery Venous thrombosis Treatment Outcome Lower Extremity cardiovascular system Female Cardiology and Cardiovascular Medicine business Vascular Surgical Procedures |
| Zdroj: | Journal of vascular surgery. Venous and lymphatic disorders. 7(6) |
| ISSN: | 2213-3348 |
| Popis: | Objective Lower extremity venous aneurysms may lead to serious morbidity in patients, including pulmonary embolism (PE) and chronic venous insufficiency. Presently, because of the low incidence of these aneurysms, no consensus for their treatment exists. The purpose of this study was to review the presentation and management of lower extremity venous aneurysms at our institution. Methods A retrospective review of all patients with isolated lower extremity venous aneurysms treated at a single tertiary care medical center from 2005 to 2017 was conducted. Results Five male and six female patients with lower extremity venous aneurysms were identified, with a mean age of 50.4 years. Three patients presented with deep venous thrombosis or PE, three presented with pain, and five venous aneurysms were found incidentally. Nine of 11 patients had aneurysms involving the popliteal vein; one was in the iliac vein, and one was in the common femoral vein. Diagnosis was made by duplex ultrasound in five patients, magnetic resonance imaging in five patients, and computed tomography venography in one patient. Mean aneurysm to adjacent vein ratio was 2.62. No patients who had venous aneurysms discovered incidentally suffered thromboembolic complications. Three patients who were initially treated conservatively went on to eventual surgical intervention. Six patients underwent surgical intervention. The indication for operation was deep venous thrombosis or PE in three patients and lower extremity swelling in three patients; all were symptomatic at presentation. Three patients had simple venorrhaphy, two patients had aneurysmectomy and ligation of the vein, and one patient underwent aneurysmectomy with placement of an interposition vein graft. Mean follow-up was 26 months, with no recurrent thromboembolism. Perioperative complications included postoperative hematoma (one) and superficial thrombophlebitis (one). Conclusions Lower extremity venous aneurysms continue to represent a rare yet potentially morbid vascular disease. Symptomatic patients demonstrated a clear benefit from surgery vs conservative management. Larger, multicenter studies are required to properly characterize the natural history and management of this disease. |
| Databáze: | OpenAIRE |
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