Anévrismes veineux

Abstract

Venous aneurysms are rare lesions that may be encountered throughout the venous system, at any age. Lower limbs are the most frequently involved, most of the time at the popliteal level; other locations include head and neck veins, and abdominal and thoracic veins. Various clinical presentations are reported in the literature. Venous aneurysms can be diagnosed as a subcutaneous or a mediastinal widening mass, as an incidentally findings on imaging study, or during work-up for abdominal or chronic venous diseases work-up. Although their natural course is usually benign, depending on their location, venous aneurysms have the potential for serious complications and may present initially as a pulmonary emboli, a thrombosis, or a rupture aneurysm. Thromboembolic complications are common in aneurysms that involve the deep vein system, particularly in popliteal aneurysms. The management of venous aneurysms remains controversial. Indication for surgery should consider potential thromboembolic complications or risks of rupture. Except for neck venous aneurysm, most venous aneurysms should be surgically treated to avoid potential morbidity or even death. Pulmonary emboli, venous thrombosis, external compression, bleeding, pain, swelling, or undefined mass are common indications. Numerous types of surgical repair have been described and the most common procedures are tangential excision with lateral venorrhaphy or excision with interposition grafting. The choice of the surgical technique is usually determined by the type of aneurysm and by the anatomical location.