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Background
Aneurysms of the iliac vein are rarely encountered in clinical practice. Etiologies can be primary (idiopathic) in nature or can be secondary to proximal obstructions or arteriovenous fistulae. We report a finding of bilateral venous aneurysms with subsequent operative repair.
Methods
We present the case of a 54 year-old previously healthy male who presented with swelling and phlegmasia dolens to bilateral lower extremities. Duplex-ultrasonography and subsequent venogram demonstrated an occluded vena cava with stenosis and bilateral iliac vein aneurysms and thrombus. Percutaneous thrombectomy in conjunction with angioplasty and stenting of the vena cava was utilized to treat the thrombus in the acute setting. While over several months there was complete resolution of the right iliac venous aneurysm, the left iliac venous aneurysm persisted, measuring approximately 4.7cm in maximum diameter. The patient was subsequently taken to the operating theater in an elective fashion for repair. The aneurysmal portion of the vein was resected sharply to create a normal size conduit which was closed primarily.
Results
Excellent flow was observed through the iliac vein with ultrasound at the conclusion of the case. Follow-up duplex-ultrasonographic and venographic studies of the left iliac vein demonstrated normal flow through the channel with no residual aneurysmal changes.
Conclusion
Iliac venous aneurysms are an extremely rare entity that when encountered can be successfully managed with tangential aneurysmectomy and lateral venorrhaphy.