Primary tibial vein aneurysm with recurrent pulmonary emboli.
We report the case of a 42-year-old man with pleuritic chest pain, shortness of breath, and associated tachycardia. Three months before, he had been treated for similar features with the diagnosis of pulmonary emboli. Computed tomography scan showed multiple bilateral pulmonary emboli. He had no clinical evidence of deep venous thrombosis, but an accurate venous duplex examination revealed a thrombosis of the posterior tibial vein aneurysm. Thrombolysis, a temporary inferior cava filter (ICV filter), and tangential aneurysmectomy and lateral venorrhaphy were performed. Accurate duplex scan evaluation of lower limb venous system is mandatory in all cases of pulmonary embolism; anticoagulation may be ineffective in preventing pulmonary embolism, and the surgical repair is treatment of choice of this pathology because it is safe and effective.
Gabrielli
Roberto
R
Department of Vascular and Endovascular Surgery, Policlinico Casilino University of Rome, Rome, Italy. rogadoc@libero.it
Rosati
Maria Sofia
MS
Costanzo
Alessandro
A
Chiappa
Roberto
R
Siani
Andrea
A
Caselli
Giovanni
G
D000328:Adult; D000783:Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D012008:Recurrence; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014656:Vascular Surgical Procedures; D014680:Veins; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy