MANAGEMENT OF VENOUS ANEURYSMS AND THEIR VASCULARSURGICAL THERAPEUTIC OPTIONS – SELECTION OF REPRESENTATIVE CASES ILLUSTRATING EXPERIENCES IN A CENTER OF VASCULAR SURGERY f.meyer@med.ovgu.de

PE054

MANAGEMENT OF VENOUS ANEURYSMS AND THEIR VASCULARSURGICAL THERAPEUTIC OPTIONS – SELECTION OF REPRESENTATIVE CASES ILLUSTRATING EXPERIENCES IN A CENTER OF VASCULAR SURGERY

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Germany

Poster Exhibition only

Venous aneurysms are a rare entity in vascular surgery.

Case series of a consecutive patient cohort with venous aneurysm in a center vascular surgery from the last 18 years.

Between 2005 and 2023, a total of 11 cases of venous aneurysms were reported in patients aged 30-84 (mean: 52.5, median: 50) years, with one patient requiring recurrence surgery after 2 years. The gender ratio was 7:3, with the popliteal vein being the most frequently affected anatomical region at 36.4%, followed by the internal jugular vein and axillary/subclavian vein at 18.2%. Aneurysm of the inferior vena cava, the common iliac vein and the cubital vein occurred only once. Surgical treatment of the aneurysms was performed in 9 cases. The surgical methods used were i) tangential resection of the aneurysm wall and continuous shirring suture, ii) resection of the aneurysm and interposition of an 8-mm GORE-TEX® vascular graft prosthesis, iii) ligation of the aneurysm and iv) ligation with subsequent resection of the aneurysm.

The rarity of venous aneurysms should give reason to register these cases centrally (eventually, Germany-wide diagnosis-related register). Surgical treatment is usually unproblematic and associated with few complications. The risk of pulmonary embolism appears to be significantly increased in venous aneurysms of the extremities, pelvic veins and inferior vena cava, while venous aneurysms of the head and neck are significantly less prone to this. Peri- and postoperative anticoagulation has adapted to the development of specific anticoagulants and novel drugs, in favor of therapy with direct oral anticoagulants (DOACs).