Acute Thrombosis of an Aneurysm of the Small Saphenous Vein: A Case Report

Background A venous aneurysm (VA) is a focal dilatation of a nonvariceal vein (diameter increased by at least 1.5 times compared to the adjacent upstream or downstream venous segment), which carries a risk of venous thromboembolism (VTE) when located in the deep veins of the lower limbs but also whe...

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Bibliographic Details
Published in:Vascular and endovascular surgery 2024-04, Vol.58 (3), p.350-356
Main Authors: Hamdan, Rémy, Precup, Calin Gheorge, Falchero, Catherine, Baldassini, Anne-Laure, Castillo, Christine
Format: Article
Language:English
Subjects:
Adult
Aneurysm - diagnostic imaging
Aneurysm - etiology
Aneurysm - surgery
Dilatation, Pathologic
Female
Humans
Male
Saphenous Vein
Thrombosis
Treatment Outcome
Varicose Veins - diagnostic imaging
Varicose Veins - surgery
Venous Insufficiency
Venous Thromboembolism
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Summary:Background A venous aneurysm (VA) is a focal dilatation of a nonvariceal vein (diameter increased by at least 1.5 times compared to the adjacent upstream or downstream venous segment), which carries a risk of venous thromboembolism (VTE) when located in the deep veins of the lower limbs but also when it affects the veins above the muscle fascia. Case We report the case of a 40-year-old woman who presented with a painful and disabling mass-like lesion of the upper third of the right calf. A Doppler ultrasound (DUS) examination revealed a small saphenous vein (SSV) dilated at the saphenopopliteal junction (SPJ) and thrombosed along its entire length. Anticoagulant treatment was initiated but although the thrombosis regressed on DUS, the functional impotence and the persistence of pain prompted a stripping of the SSV. Histology allowed the diagnosis of SSV’s primary aneurysm. Discussion Dilated segments of the saphenous vein are not always varicose veins (VVs). True VAs can develop on veins located above the muscular fascia and, like deep VAs, may trigger VTE. Small saphenous vein aneurysms have seldom been reported, and only a few clinical observations have described the thrombosis of a SSV aneurysm. Any mass in the popliteal fossa or upper part of the calf should be examined by DUS to look for an SSV aneurysm. Excision of the saphenous vein with junctional ligation is advised if thrombosis is present at the time of diagnosis.
ISSN:1538-5744
1938-9116
DOI:10.1177/15385744231215571