Venous aneurysms: To treat or not to treat

To The Editor,

I read with great interest the editorial by Cruddas et al. ¹ that was published recently and wanted to congratulate the authors for their contribution to the subject.

These aneurysms are indeed rare and little is known about their natural history. Because of their rarity, little consensus exists about their management. Endovascular stenting, although infrequently described, appears to be an attractive option for managing these aneurysms. ² But open surgery remains the standard of care.

The best studied amongst these venous aneurysms is perhaps the popliteal venous aneurysm, highly notorious for its association with venous thrombosis and pulmonary embolism (PE). At many centers, these are generally repaired, even if asymptomatic regardless of their size because of the high risk for PE.

Moreover, little is known about possible associations of these venous aneurysms. For instance, a possible association between popliteal venous aneurysms and iliac vein compression was proposed in 2014. ³

Lastly, venous aneurysms are particularly well suited to investigation through the Vascular Low Frequency Disease Consortium (VLFDC) because of their rarity and inconsistent management modus operandi in literature. ⁴ VLFDC has so far been utilized mostly for uncommon arterial conditions including, but not limited to, renal artery aneurysms, femoral artery aneurysms, and carotid body tumors. ⁴