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OftalmoloΕ‘ka poliklinika Dr. Balog

The VAs of the extremities can be classified into two types: aneurysms of the deep and of the superficial venous system. This distinction is important, because aneurysms of the deep system have a greater association with thromboembolism and more severe venous morbidity than those of the superficial system 1. Historically, superficial VAs of lower extremities are considered rare 1 , but Pascarella et al. The precise prevalence of the deep and the superficial VAs is still unknown 3. The first characterization of this entity was from the autopsy by Osler in , while the first true venous aneurysm of the popliteal vein was described in by May and Nissel 4.

Dahl et al. A wide variety of venous aneurysms clinical presentations of the lower extremities are reported in the literature. Many are mistaken for soft tissue masses of the lower extremities either with or without pain VAs have also been misdiagnosed as inguinal or femoral hernias or limphadenopathy A case of posterior tibial vein aneurysm presenting as tarsal tunnel syndrome has been described Abdominal pain, lower limb oedema and palpable mass in the iliac area have been described in a case of iliac vein aneurism - only 8 of these have been described in the literature so far In the recent literature a case of missed superficial venous aneurysm at the saphenofemoral junction on preoperative duplex scanning in a patient with lower extremity venous stasis ulcers was reported Patients may present only with varicose veins or with superficial vein insufficiency, as a part of a chronic venous disease 1.

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It is of great importance to recognize this entity due to possible complications and appropriate treatment. The definition of a VA still remains controversial and there are no precise criteria as to vessel diameter to define a venous dilatation as aneurysmal. VA definition regarding size and other morphology characteristics differs widely in the literature.

In general, term aneurysm is used to indicate a permanent and irreversible localized vascular dilatation that involves all three layers of the blood vessel wall. It may develop in any part of the circulatory system, including veins. In Gillespie at al. Most importantly, it should not be contained within a segment of varicose vein Later, in more concise definition of VA as a solitary area of fusiform or saccular dilatation occurring in the course of a major vein or connected by a single channel to a major venous structure was defined by Perrotta In some studies VAs are defined as a persistent isolated dilatation of twice the normal vein diameter 21 or three times in its normal size In Chen suggested definition of VA as a segment that is 1.

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Regardless of its definition, it is important to diagnose VAs, due they could be a source of significant morbidity and even death if left untreated. Venous system aneurysms are reported at any age, irrespective of gender There is no consensus in the literature about the most frequent location of venous aneurysms.

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