ABSTRACT
The cases of paradoxical brain embolism (PBE) due to venous aneurysms and patent foramen ovale (PFO) are extremely scarce, with only 5 cases caused by popliteal venous aneurysm reported in the literature to date, while PBE caused by deep femoral venous aneurysm (DFVA) and PFO has not been reported. Herein, an unusual case of PBE in a 15-year-old girl with PFO who still had cerebral infarction and pulmonary embolism after transcatheter closure was present. She was finally diagnosed as PFO with DFVA by angiography. Furthermore, clinical characteristics of 6 cases were summarized to improve the clinicians′ recognition of the rare risk factor of stroke-venous aneurysms of the lower extremity deep veins.
ABSTRACT
Popliteal venous aneurysm (PVA) is recognized as source of fatal pulmonary embolism ; surgical treatment is indicated. A 79-year-old woman presented with acute shortness of breath. A cardiac ultrasound echography showed right heart overload and pulmonary hypertension. A contrast enhanced CT revealed multiple pulmonary artery emboli and right popliteal venous aneurysm. She was immediately started anticoagulation therapy with oral factor Xa inhibitor and her dyspnea improved. As thrombus in venous aneurysm was considered the cause of the pulmonary embolism, we recommended surgical treatment. Tangential aneurysmectomy with lateral venorrhaphy for the saccular venous aneurysm was performed. Postoperative contrast enhanced CT showed good morphology and she was discharged without complication. Surgical treatment of symptomatic popliteal venous aneurysm is considered useful strategy.
ABSTRACT
RESUMEN Introducción: dos complicaciones frecuentes que presentan mal función de las fístulas arteriovenosas internas son la trombosis y la estenosis. Otras complicaciones como los aneurismas, aunque de menor frecuencia, no dejan de ser importantes. Estas requieren una intervención a tiempo para evitar el fracaso de dicho acceso. Presentación del caso: paciente que es intervenido por aneurisma venoso de fístula arteriovenosa interna y tratado con aneurismectomía total. No se preservó el acceso vascular. Se colocó catéter temporal en yugular interna derecha en espera de la realización de un nuevo acceso vascular, sin complicaciones. Conclusiones: el tratamiento es a criterio del cirujano vascular debido a los elementos clínicos encontrados, así como a los cambios degenerativos a consecuencia del proceso inflamatorio local. Los aneurismas de las fístulas arteriovenosas constituyen una complicación con frecuencia baja, pero que no están exentos de la ruptura. Se observa tanto en fístulas arteriovenosas autólogas como en injertos autólogos y heterólogos. El peligro de rotura espontánea en un sitio de afinamiento marcado de la piel a consecuencia de punciones repetidas, constituye una indicación para tomar una conducta quirúrgica con prontitud. Además, es importante que el equipo multidisciplinario esté al cuidado de la fistula durante todo el tiempo de vida útil.
ABSTRACT Introduction: two frequent complications that present a poor function of the internal arteriovenous fistulas are thrombosis and stenosis. Other complications such as aneurysms, although less frequent, are not unimportant; they require a timely intervention to avoid the failure of such approach. Case report: a patient who is intervened due to a venous aneurysm of internal arteriovenous fistula and treated with total aneurysmectomy. Vascular approach was not preserved; a temporary catheter was placed in the right internal jugular vein while waiting for a new vascular approach to be made, and there were no complications. Conclusions: the treatment is at the discretion of the vascular surgeon; due to the clinical elements found, as well as the degenerative changes as a result of the local inflammatory process. The aneurysms of the arteriovenous fistulas constitute a complication of low frequency, but they are not exempt from rupture. It is observed both in autologous arteriovenous fistulas and in autologous and heterologous grafts. The danger of spontaneous rupture at a marked skin-toning site as a result of repeated punctures is an indication for prompt surgical procedure. The treatment is at the discretion of the vascular surgeon and it is important the multidisciplinary team cares for the fistula during its projected lifespan.
ABSTRACT
Venous aneurysm is saccular or fusiform dilatation of vein, usually congenital origin. Among acquired variety post intravenous cannulation leading to venous aneurysm is extremely rare entity. Non invasive diagnostic procedure MRI and duplex scanning are very useful modality for anatomical localization of the aneurysm. Although an ascending venogram is an invasive test and should take a backseat for diagnosis of such aneurysm. Symptometic case needs surgical management. Anatomical delineation is an important pre requisite for planning surgery. Aneurysmorrhaphy preserves the affected venous segment because it does not produce luminal compromise.
ABSTRACT
Superior mesenteric venous aneurysm (SMVA) is rare and no standard treatment protocol has yet been established. We report our experience in performing surgical treatment for SMVA. A 64-year-old man was found to have a SMVA by computed tomography which had been performed during follow-up for gastrectomy. The SMVA was observed to gradually increase in diameter, and surgical treatment was therefore indicated. We successfully resected the aneurysm and then closed the defect with a bovine pericardial patch. Considering the potential risk of rupture, venous aneurysms that present with a saccular shape and an expanding tendency should be immediately surgically treated.
ABSTRACT
Intracranial pial arteriovenous fistulas (AVFs) are rare vascular lesions of the brain. These lesions consist of one or more arterial connection to a single venous channel without true intervening nidus. A 24-year-old woman visited to our hospital because of headache, vomiting, dizziness and memory disturbance that persisted for three days. She complained several times of drop attack because of sudden weakness on both leg. Cerebral angiograms demonstrated a giant venous aneurysm on right frontal lobe beyond the genu of corpus callosum, multiple varices on both frontal lobes fed by azygos anterior cerebral artery, and markedly dilated draining vein into superior sagittal sinus, suggesting single channel pial AVF with multiple varices. Transarterial coil embolization of giant aneurysm and fistulous portion resulted in complete disappearance of pial AVF without complication.
Subject(s)
Female , Humans , Young Adult , Aneurysm , Anterior Cerebral Artery , Arteriovenous Fistula , Brain , Corpus Callosum , Dizziness , Embolization, Therapeutic , Frontal Lobe , Headache , Leg , Memory , Superior Sagittal Sinus , Syncope , Varicose Veins , Veins , VomitingABSTRACT
Objective: To summarize the major ultrasonic manifestations of various hepatic vascular anomaly(HVA), so as to improve the ultrasonic diagnosis rate of HVA. Methods: The chief complaints, timing and mode of ultrasonic diagnosis of 18 patients with congenital HVA or post-liver transplantation HVA were retrospectively analyzed. Six of the 18 patients were subjected to detailed analysis. The major ultrasonic manifestations of various HVA were observed and experience of ultrasonic diagnosis was summarized. Results: The major vascular abnormalities in our group included hepatic vascular fistula (including fistulas between artery and vein, artery and portal vein, portal vein and hepatic vein, also a complex fistula among artery, portal vein and hepatic vein), portal aneurysm, congenital portal atresia and portal vein cavernous transformation; among which the portal atresia and the complex hepatic fistula involving hepatic artery, hepatic vein and portal vein were rarely described in the literature. Color Doppler ultrasound was the first choice for detection and diagnosis of HVA; contrast-enhanced ultrasound was sensitive and specific in diagnosis of all vascular fistulas due to its ability to display homodynamic phase. Conclusion: The wide application of Doppler and contrast-enhanced ultrasound examination improves the detection and diagnosis of HVA; diagnosis should be made based on scientific diagnosis mode and precise diagnosis planning.
ABSTRACT
Primary venous aneurysm is a rarely encountered vascular disease in clinical practice. In contrast to deep venous aneurysm, superficial venous aneurysms are at low risk for thrombotic complications. Surgical excision is often recommended when they become symptomatic. We present here a case of true aneurysm of the great saphenous vein (GSV) in a 16-year-old girl who complained of a painful mass in the right inguinal area. Doppler sonography and CT-venography showed a vascular pool in the right inguinal area, and this was suspicious for being an aneurysm or a pseudoaneurysm that originated from the GSV. This saccular mass was completely excised and it was proved to be a true aneurysm of the great saphenous vein on the pathologic examination. Venous aneurysm should always be considered in the differential diagnosis of a subcutaneous mass, although it is a rare vascular anomaly.
Subject(s)
Adolescent , Humans , Aneurysm , Aneurysm, False , Diagnosis, Differential , Saphenous Vein , Vascular DiseasesABSTRACT
Pure sylvian fissure arteriovenous malformations(AVMs) are vascular malformations confined to the sylvian fissure without parenchymal involvement. Surgical removal is regarded as difficult because the nidus is located just lateral to important structures such as the basal ganglia and the internal capsule. Because most feeding arteries to the nidus are branches of the middle cerebral artery(MCA), differentiation between these feeders from en passant and normal vessels is of great importance in order to reduce morbidity and mortality from surgical intervention. We report a case of pure sylvian fissure AVM who presented with an intra-temporal lobe hematoma that was located around venous aneurysms distant from the nidus. The clinical characteristics of this AVM and the surgical methods employed to avoid complications are discussed.
Subject(s)
Aneurysm , Arteries , Arteriovenous Malformations , Basal Ganglia , Hematoma , Internal Capsule , Mortality , Vascular MalformationsABSTRACT
A giant intracranial venous aneurysm(varix) is rare and has been associated mostly with vein of Galen fistulae. A 32-year-old man presents with intracranial hemorrhage which was caused by the rupture of supratentorial arteriovenous malformation with giant venous aneurysm. Surgical resection was performed without the occurrence of additional neurological deficits. We review the literatures on this clinical entity.
Subject(s)
Adult , Humans , Aneurysm , Arteriovenous Malformations , Cerebral Veins , Fistula , Intracranial Arteriovenous Malformations , Intracranial Hemorrhages , RuptureABSTRACT
A 70-year-old woman presented with extending varicose veins of her left lower extremity. She had a Seventeen years previously she suffered a stab wound in her left lower extremity. She had a thrill in her left groin and a pulsatile mass in her lower abdomen on the left side. Venography showed ‘to and fro’ sign in her popliteal vein. Arteriography and computed tomography (CT) scan revealed left popliteal arteriovenous fistula and dilated femoral artery and vein, in addition to a giant iliac venous aneurysm (9cm in diameter). The shunt ratio was calculated at 3.4. We separated the fistula using ringed ePTFE grafts. After the operation, her varicose veins remarkably diminished. CT scans showed that the iliac venous aneurysm diminished to 3.6cm with no internal thrombus at three weeks after the operation. Cases of traumatic arteriovenous fistula with venous aneurysm that occurred in parts other than the fistula are rare and there are only two cases in the international literature.
ABSTRACT
A 13-year-old girl with asplenia syndrome who previously had undergone left subclavian-to-pulmonary artery shunt after removal of a cavopulmonary shunt with interposition of a short segment of the left superior vena cava was admitted for congestive heart failure. Angiography revealed aneurysmal dilatation of the left superior vena cava. Percutaneous coil embolization of the shunt was successfully performed and the venous aneurysm was diminished. Interposition of a venous component in systemic-to-pulmonary artery shunt should be avoided even after removing a cavopulmonary shunt.
ABSTRACT
A case of lateral neck mass caused by thrombosis of the right external jugular vein is presented. Macroscopic examination of the excised thrombosed vein showed a pin-point opening of the jugular vein connecting to the hemorrhagic mass and microscopic examination revealed the vein to have an organized thrombus with somewhat degenerated vessel walls. Venipuncture would seem the most likely cause of thrombosis of the venous aneurysm in this 6 year old female patient.
Subject(s)
Child , Female , Humans , Aneurysm , Jugular Veins , Neck , Phlebotomy , Thrombosis , VeinsABSTRACT
A case of AVM(Arteriovenous Malformation) harboring a large venous aneurysm is presented. The AVM was located in right temporo-parietal area. The pathology revealed a AVM and large venous aneurysm which was attached to nidus and drained into petrosal sinus. The authors reviewed the pathology of AVM and venous aneurysm.