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血栓性下肢静脉动脉瘤的综合管理:单中心回顾性分析及临床策略见解。

Comprehensive Management of Thrombosed Lower Extremity Venous Aneurysms: A Single-Center Retrospective Analysis and Insights Into Clinical Strategies.

机构信息

Cardiovascular Surgery Department, Bozok University Faculty of Medicine, Yozgat, Turkey.

Emergency and Disaster Management Department, Bozok University Faculty of Health Sciences, Yozgat, Turkey.

出版信息

Vasc Endovascular Surg. 2024 Nov;58(8):854-861. doi: 10.1177/15385744241276695. Epub 2024 Aug 22.

Abstract

OBJECTIVE

Venous aneurysms are rare vascular abnormalities associated with venous thromboembolism. In this study, we presented our experience in managing thrombosed lower extremity venous aneurysms and evaluate the impact of vitamin D deficiency and genetic thrombophilic risk factors on patient management and outcomes.

METHODS

A single-center retrospective observational analysis was conducted on ten patients with thrombosed lower limb venous aneurysms who underwent surgical procedures at our hospital from July 2014 to February 2023. Collected data included venous duplex ultrasonographic imaging and laboratory tests including genetic thrombophilic risk factors and assessments of vitamin D levels.

RESULTS

There were 5 males and 5 females. The mean age was 46.6 ± 12.1 years. The aneurysms were located in the popliteal vein in three patients, the great saphenous vein in six, and the small saphenous vein in one. Venous duplex imaging revealed saccular aneurysms in eight patients and fusiform aneurysms in two, with a mean diameter of 37.2 ± 10.6 mm, ranging from 23 to 52 mm. Laboratory tests indicated vitamin D deficiency in all of the patients, and genetic thrombophilic risk factors were identified in two cases. Surgical interventions consisted of tangential excision with lateral venorrhaphy in three patients and total excision and ligation in seven patients. The postoperative period was favorable for all patients.

CONCLUSIONS

Surgical treatment of thrombosed venous aneurysms in the lower extremities is essential to prevent complications such as thromboembolism. A comprehensive approach, including knowledge of genetic risk factors and vitamin D levels, may improve patient outcomes.

摘要

目的

静脉瘤是一种罕见的与静脉血栓栓塞相关的血管异常。在本研究中,我们报告了我们处理血栓性下肢静脉瘤的经验,并评估了维生素 D 缺乏和遗传易栓症危险因素对患者管理和结局的影响。

方法

对 2014 年 7 月至 2023 年 2 月期间在我院接受手术治疗的 10 例血栓性下肢静脉瘤患者进行单中心回顾性观察分析。收集的数据包括静脉双功超声影像学和实验室检查,包括遗传易栓症危险因素和维生素 D 水平评估。

结果

患者中有 5 名男性和 5 名女性。平均年龄为 46.6±12.1 岁。动脉瘤位于 3 例患者的腘静脉、6 例患者的大隐静脉和 1 例患者的小隐静脉。静脉双功超声显示 8 例患者为囊状动脉瘤,2 例为梭形动脉瘤,平均直径为 37.2±10.6mm,范围为 23-52mm。实验室检查发现所有患者均存在维生素 D 缺乏,2 例存在遗传易栓症危险因素。手术干预包括 3 例患者的切线切除和侧静脉吻合术,7 例患者的全部切除和结扎术。所有患者的术后情况均良好。

结论

手术治疗下肢血栓性静脉瘤对于预防血栓栓塞等并发症至关重要。综合考虑遗传风险因素和维生素 D 水平等因素,可能会改善患者的结局。

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