Aneurysms of the venous system

Overall, aneurysms of the venous system constitute a rare disease. Up to March 2016, 1,199 venous aneurysms at various locations had been reported in the literature. The most common were aneurysms of the extrahepatic portal vein (n=247), followed by popliteal venous aneurysms (n=223) and, in third place, aneurysms of the internal or external jugular vein (n=143). Venous aneurysms are not usually diagnosed until they have become symptomatic or have led to complications, such as thrombosis and/or pulmonary embolism. First-line treatment of symptomatic aneurysms is resection of the aneurysm and reconstruction of the vein using either direct suture or end-to-end anastomosis, depending on the location. Endovenous repairs have also been described in the literature. Venous aneurysms of the superficial venous system can usually be excised and the vein ligated. Long-term anticoagulation is reserved for isolated cases with thrombotic occlusion and recurrent pulmonary embolisms.