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      Blunt traumatic subclavian vein pseudoaneurysm

      case-report
      , MD a , b , c , , MD a , b , , MD, MSc, FRCSC a , b , c ,
      Journal of Vascular Surgery Cases
      Elsevier

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          Abstract

          Subclavian and upper extremity venous pseudoaneurysms are rare and poorly understood. We present the case of a 45-year-old woman with a right subclavian vein pseudoaneurysm that formed after blunt trauma to the upper chest and shoulder. The patient was managed successfully with surgical excision through a supraclavicular approach. The case report is followed by a discussion on the etiology, clinical presentation, and management of venous pseudoaneurysms.

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          Most cited references13

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          Venous aneurysms: surgical indications and review of the literature.

          During the last 20 years we diagnosed five cases of venous aneurysm of the jugular (n = 4) and basilic (n = 1) veins. The purpose of this report was to determine the natural history and indications for surgery of venous aneurysms. Our five cases were included in an English-language literature review performed through August 1993. In our series two aneurysms (one external jugular vein, one basilic vein) were excised for cosmetic reasons. Three internal jugular vein aneurysms were followed up for up to 4 years without complications with serial color duplex ultrasonography. Of 32 patients with abdominal venous aneurysms (18 portal, seven inferior vena cava, four superior mesenteric, two splenic, one internal iliac), 13 (41%) had major complications including five deaths. Of 31 patients with deep venous aneurysms of the extremity (29 popliteal, two common femoral), 22 (71%) had deep vein thrombosis or pulmonary embolism and in 17 recurrent deep vein thrombosis or pulmonary embolism developed when patients were treated with anticoagulation alone. Prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for most patients with lower extremity deep venous aneurysms. Other venous aneurysms should be excised only if they are symptomatic, enlarging, or disfiguring.
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            Subclavian venous aneurysm: case report and review of the literature.

            A case of a symptomatic 5.1-cm left subclavian venous aneurysm, which was treated with surgical excision, is presented. Most venous aneurysms in the head and neck region involve the internal or external jugular veins and are asymptomatic. Aneurysms involving the subclavian or axillary veins are rare. The natural history of these aneurysms is benign with no reported instances of rupture or thromboembolic events. Operative treatment is most often undertaken for cosmetic reasons or for the development of symptoms.
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              Acquired Jugular Vein Aneurysm

              Venous malformations of the jugular veins are rare findings. Aneurysms and phlebectasias are the lesions most often reported. We report on an adult patient with an abruptly appearing large tumorous mass on the left side of the neck identified as a jugular vein aneurysm. Upon clinical examination with ultrasound, a lateral neck cyst was primarily suspected. Surgery revealed a saccular aneurysm in intimate connection with the internal jugular vein. Histology showed an organized hematoma inside the aneurysmal sac, which had a focally thinned muscular layer. The terminology and the treatment guidelines of venous dilatation lesions are discussed. For phlebectasias, conservative treatment is usually recommended, whereas for saccular aneurysms, surgical resection is the treatment of choice. While an exact classification based on etiology and pathophysiology is not possible, a more uniform taxonomy would clarify the guidelines for different therapeutic modalities for venous dilatation lesions.
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                Author and article information

                Contributors
                Journal
                J Vasc Surg Cases
                J Vasc Surg Cases
                Journal of Vascular Surgery Cases
                Elsevier
                2352-667X
                29 August 2015
                September 2015
                29 August 2015
                : 1
                : 3
                : 214-216
                Affiliations
                [a ]Division of Vascular Surgery, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada
                [b ]Department of Surgery, University of Toronto, Toronto, Ontario, Canada
                [c ]Department of Surgery, King Saud University, Riyadh, Kingdom of Saudi Arabia
                Author notes
                []Correspondence: Mohammed Al-Omran, MD, MSc, FRCSC, Professor and Head, Division of Vascular Surgery, St. Michael's Hospital, 30 Bond St, Ste 7-074, Bond Wing, Toronto, Ontario, M5B 1W8, Canada alomranm@ 123456smh.ca
                Article
                S2352-667X(15)00088-0
                10.1016/j.jvsc.2015.07.001
                6849976
                4b4a1e90-662a-4285-a4ff-34e2c9c7154e
                © 2015 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 13 March 2015
                : 13 July 2015
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