scholarly journals Management of Symptomatic Venous Aneurysm

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Roberto Gabrielli ◽  
Maria Sofia Rosati ◽  
Andrea Siani ◽  
Luigi Irace
Keyword(s):  
Pulmonary Embolism ◽  
Paradoxical Embolism ◽  
Lower Limbs ◽  
Venous Aneurysm ◽  
Pulmonary Emboli ◽  
Duplex Scan ◽  
Deep Venous System ◽  
Simple Excision ◽  
Life Threatening ◽  
Aneurysm Thrombosis

Venous aneurysms (VAs) have been described in quite of all the major veins. They represent uncommon events but often life-threatening because of pulmonary or paradoxical embolism. We describe our twelve patients’ series with acute pulmonary emboli due to venous aneurysm thrombosis. Our experience underlines the importance of a multilevel case-by-case approach and the immediate venous lower limbs duplex scan evaluation in pulmonary embolism events. Our data confirm that anticoagulant alone is not effective in preventing pulmonary embolism. We believe that all the VAs of the deep venous system of the extremities should be treated with surgery as well as symptomatic superficial venous aneurysm. A simple excision can significantly improve symptoms and prevent pulmonary embolism.

Pulmonary emboli due to venous aneurysm of extremities

VASA ◽  
2011 ◽  
Vol 40 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Gabrielli ◽  
Rosati ◽  
Vitale ◽  
Millarelli ◽  
Siani ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Surgical Resection ◽  
Potential Risk ◽  
Acute Pulmonary Embolism ◽  
Prophylactic Surgery ◽  
Venous Aneurysm ◽  
Pulmonary Emboli ◽  
Thromboembolic Events ◽  
Thromboembolic Complications ◽  
Risk Patients

Venous aneurysms are uncommon but they can have devastating consequences, including pulmonary embolism, other thromboembolic events and death. We report six cases of venous aneurysm of the extremities, in which the first sign of presence was acute pulmonary embolism. Surgical resection is recommended whenever possible. Our experience suggests that prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for extremity deep and superficial venous aneurysms for their potential risk of developing thromboembolic complications despite adequate anticoagulation. Other venous aneurysms should be excised only if they are symptomatic or enlarging.

Primary Venous Aneurysms of the Popliteal Fossa

1993 ◽  
Vol 8 (2) ◽  
pp. 82-85 ◽  
Author(s):  
T. R. Cheatle ◽  
M. Perrin
Keyword(s):  
Pulmonary Embolism ◽  
Outcome Measures ◽  
Surgical Repair ◽  
Postoperative Recovery ◽  
Popliteal Fossa ◽  
Venous Aneurysm ◽  
Pulmonary Emboli ◽  
Radiological Evidence

Objective: To report five cases of primary venous aneurysm arising in the popliteal fossa. Setting: Unite de Pathologie Vasculaire Jean Kunlin, Clinique du Grand-Large, av. Leon-Blum, Decines Charpieu, France. Patients: Five patients with radiological evidence of venous aneurysm in the popliteal fossa. Interventions: Surgical repair in all cases. Main outcome measures: Avoidance of pulmonary embolism. Results: Satisfactory postoperative recovery in all. No complications or subsequent pulmonary emboli.

Pulmonary embolism

2021 ◽  
pp. 463-472
Author(s):  
Terry Robinson ◽  
Jane Scullion
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Amniotic Fluid ◽  
High Flow ◽  
Lower Limbs ◽  
Pulmonary Emboli ◽  
Common Cause ◽  
High Flow Oxygen ◽  
Clinically Significant ◽  
The Right

A pulmonary embolism (PE) is a clinically significant obstruction occurring in part of or the entire pulmonary vascular tree. The most common cause is a thrombus from a distant site such as the leg. Most pulmonary emboli originate from detached portions of venous thrombi that have formed in the deep veins of the lower limbs. Other sites where they form include the right side of the heart and the pelvis. Non-thrombotic emboli, mainly fat, air, and amniotic fluid, may also occur but these are rarer. This chapter provides an overview of incidence and aetiology, and tabulates the risk factors for PE. The clinical features and assessment are covered, and six different investigations are explained. Management—anticoagulants, thrombolysis, and high-flow oxygen—are also included, along with nurse involvement at different points of PE.

Wide-ranging clinical spectrum of paradoxical embolism

2021 ◽  
pp. postgradmedj-2020-139691
Author(s):  
Oscar Jolobe
Keyword(s):  
Pulmonary Embolism ◽  
Arteriovenous Malformations ◽  
Coronary Circulation ◽  
Vena Cava ◽  
Paradoxical Embolism ◽  
Lower Limbs ◽  
Atrial Septal Aneurysm ◽  
Pulmonary Arteriovenous Malformations ◽  
Mesenteric Circulation ◽  
Venous Shunt

The purpose of this review is to raise the index of suspicion for paradoxical embolism among generalists. The review is based solely on anecdotal reports compiled from EMBASE, MEDLINE, Googlescholar and Pubmed. Search terms were ‘paradoxical embolism’, ‘pulmonary embolism’ and ‘pulmonary arteriovenous malformations’. What emerged was that right-to-left paradoxical embolism could occur with or without concurrent pulmonary embolism, and also with and without proof of the presence of an ‘embolus-in-transit’. Potential sites of single or multiple systemic involvement included the central nervous system, the coronary circulation, renal arterial circulation, splenic circulation, the mesenteric circulation and the limbs. In many cases, the deep veins of the lower limbs were the source of thromboembolism. In other cases, thrombi originated from an atrial septal aneurysm, from a central venous line, from a haemodialysis-related arterio-venous shunt, from a popliteal vein aneurysm, internal jugular vein, superior vena cava, from a pulmonary arteriovenous malformation, from tricuspid valve endocarditis (with and without pulmonary embolism) and from the right atrium, respectively. Stroke was by far the commonest systemic manifestation of paradoxical embolism. Some strokes were attributable to pulmonary arteriovenous malformations with or without coexistence of intracardiac shunts. Clinicians should have a high index of suspicion for paradoxical embolism because of its time-sensitive dimension when it occurs in the context of involvement of the intracranial circulation, coronary circulation, mesenteric circulation, and peripheral limb circulation.

scholarly journals The unfortunate miss: a saddle pulmonary embolism

2017 ◽  
Vol 5 (1) ◽  
pp. 136
Author(s):  
William Li ◽  
Marek Gruca ◽  
Bhaskara Madhira
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Ct Angiography ◽  
Imaging Modality ◽  
Pulmonary Emboli ◽  
Efficient Management ◽  
Threatening Condition ◽  
Life Threatening ◽  
Surgical Thrombectomy ◽  
Prompt Diagnosis

Pulmonary embolism is a potentially life-threatening condition that requires prompt diagnosis and efficient management such as in the form of thrombolysis or surgical thrombectomy. Saddle pulmonary emboli occurring at the bifurcation of the pulmonary artery are especially dangerous as they put afflicted individuals at risk for sudden hemodynamic collapse. While CT Angiography at present is the current imaging modality of choice, times exist when they are contraindicated and V/Q scintigraphy is used as the choice alternative. We present a rare catastrophic case of a saddle pulmonary embolism in an individual with a low-probabilityinterpretation on V/Q scintigraphy despite a clear depiction of the thrombus on echocardiography.

Percutaneous Closure of Patent Foramen Ovale in the Setting of Pulmonary Embolism (Right-Left Shunt Causing Severe Hypoxia)

2020 ◽  
Vol 15 (5) ◽  
pp. 478-480
Author(s):  
Joel Johnson ◽  
Arber Kodra ◽  
Craig Basman ◽  
S. Jacob Scheinerman ◽  
Nirav Patel ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Patent Foramen Ovale ◽  
Paradoxical Embolism ◽  
Percutaneous Closure ◽  
Foramen Ovale ◽  
Right Ventricular Strain ◽  
Long Term Follow Up ◽  
Life Threatening

A patent foramen ovale (PFO) is well known to cause paradoxical embolism and stroke, but a less appreciated and life-threatening complication can occur when combined with severe pulmonary embolism (PE). Acutely elevated right-sided pressures from right ventricular strain due to PE can lead to right-to-left (R-L) shunting through the PFO and exacerbate hypoxia. We report a case of a 50-year-old female patient with massive PE with further desaturation from R-L shunting from a PFO that benefitted from percutaneous closure of the interartrial communication. Our patient recovered without any complications and had excellent long-term follow-up.

Unusual localization of a primary superficial venous aneurysm: a case report

2012 ◽  
Vol 29 (4) ◽  
pp. 267-268 ◽  
Author(s):  
M Cakia ◽  
O Ersoy ◽  
I Ince ◽  
U Kiziltepe
Keyword(s):  
Radial Nerve ◽  
Clinical Presentation ◽  
Varicose Veins ◽  
Clinical Results ◽  
Cephalic Vein ◽  
Wrist Pain ◽  
Lower Limbs ◽  
Venous Aneurysm ◽  
Simple Excision

Objectives Primary aneurysms of superficial venous system are rare and frequently misdiagnosed as varicose veins. Clinical presentation is variable depending on the presence of compression to surrounding structures. We report a rare case of primary cephalic vein aneurysm presented with wrist pain due to radial nerve compression. Method/case A 61-year-old woman was admitted with right wrist pain and localized mass. Physical and imaging examinations showed a localized cephalic vein aneurysm compressing radial nerve. Simple excision was performed successfully. Results Cosmetic and clinical results at the first month follow-up were successful. Discussion Although primary superficial venous aneurysms of upper extremities are very rare, the treatment of choice is most commonly same as the ones in lower limbs. Simple excision is the best approach in the most of the cases, while sclerotherapy could be preferred in order to obtain better cosmesis or to avoid injuries to surrounding structures.

Aneurysma der V. poplitea als Ursache multipler Lungenembolien

VASA ◽  
2003 ◽  
Vol 32 (4) ◽  
pp. 221-224 ◽  
Author(s):  
Sigg ◽  
Koella ◽  
Stöbe ◽  
Jeanneret
Keyword(s):  
Pulmonary Embolism ◽  
Vena Cava ◽  
Young Patients ◽  
Left Knee ◽  
Popliteal Vein ◽  
High Rate ◽  
Venous Aneurysm ◽  
Pulmonary Emboli ◽  
Duplex Imaging ◽  
Lung Scan

Generally, most aneurysms of the venous system are probably congenital and rarely have clinical significance. Popliteal aneurysms are an exception of this rule and are known to be a source of recurrent pulmonary emboli. We present a previously healthy 42 year old man with multiple pulmonary emboli, diagnosed with a high probability lung scan. Venous duplex imaging and magnet resonance imaging showed a mass with connection to the popliteal vein of the left knee, suggesting a venous aneurysm. Despite therapeutic anticoagulation he suffered further pulmonary emboli. After insertion of a temporary vena cava inferior filter aneurysm resection and patch reconstruction of the popliteal vein was performed. By duplex imaging we proved the patency of the popliteal vein after surgical repair. Popliteal venous aneurysms should be kept in mind as possible thromboembolic source in young patients with pulmonary embolism. Our review of the current literature about popliteal venous aneurysms revealed a high rate of pulmonary embolism.

A Comparative Analysis of D-Dimer Assays in Patients with Clinically Suspected Pulmonary Embolism

1993 ◽  
Vol 70 (03) ◽  
pp. 408-413 ◽  
Author(s):  
Edwin J R van Beek ◽  
Bram van den Ende ◽  
René J Berckmans ◽  
Yvonne T van der Heide ◽  
Dees P M Brandjes ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Comparative Analysis ◽  
High Probability ◽  
Pulmonary Emboli ◽  
Plasma Samples ◽  
Suspected Pulmonary Embolism ◽  
Lung Scan ◽  
D Dimer

SummaryTo avoid angiography in patients with clinically suspected pulmonary embolism and non-diagnostic lung scan results, the use of D-dimer has been advocated. We assessed plasma samples of 151 consecutive patients with clinically suspected pulmonary embolism. Lung scan results were: normal (43), high probability (48) and non-diagnostic (60; angiography performed in 43; 12 pulmonary emboli). Reproducibility, cut-off values, specificity, and percentage of patients in whom angiography could be avoided (with sensitivity 100%) were determined for two latex and four ELISA assays.The latex methods (cut-off 500 μg/1) agreed with corresponding ELISA tests in 83% (15% normal latex, abnormal ELISA) and 81% (7% normal latex, abnormal ELISA). ELISA methods showed considerable within- (2–17%) and between-assay Variation (12–26%). Cut-off values were 25 μg/l (Behring), 50 μg/l (Agen), 300 μg/l (Stago) and 550 μg/l (Organon). Specificity was 14–38%; in 4–15% of patients angiography could be avoided.We conclude that latex D-dimer assays appear not useful, whereas ELISA methods may be of limited value in the exclusion of pulmonary embolism.

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