title: Upper extremity venous aneurysm as a source of pulmonary emboli.
abstract: Spontaneous venous aneurysms of the upper extremities and neck are rare and typically asymptomatic. We present the first reported case of a symptomatic, primary upper extremity venous aneurysm in a patient who initially presented with pulmonary emboli. A 22-year-old patient was admitted with chest pain, dyspnea, and a right axillary mass. Computed tomography revealed diffuse, bilateral pulmonary emboli in addition to a thrombosed axillary vein. Venography confirmed the diagnosis, and also revealed a subclavian vein stenosis at the crossing of the first rib. Pharmacomechanical thrombolysis, catheter-directed thrombolysis, and venoplasty were performed with adequate flow restoration, also revealing the presence of a previously thrombosed proximal brachial/distal axillary venous aneurysm. Hematologic testing showed a positive and persistent lupus anticoagulant. The patient declined surgical reconstruction and opted for long-term anticoagulation. At 24 months, the patient continued to remain symptom-free.
authors: Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
authors: Justin R
authors: JR
authors: Wallace
authors: Donald T
authors: DT
authors: Baril
authors: Rabih A
authors: RA
authors: Chaer
mesh_terms: D000783:Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000925:Anticoagulants / Q000627:therapeutic use; D001367:Axillary Vein / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis; D010690:Phlebography / Q000379:methods; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013901:Thoracic Outlet Syndrome / Q000150:complications; D015912:Thrombolytic Therapy; D019851:Thrombophilia / Q000150:complications; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D055815:Young Adult
chemical_list: D000925:Anticoagulants
references: Acta Radiol. 2005 Jul;46(4):366-7
references: 16134311
references: Surg Today. 2005;35(6):496-8
references: 15912300
references: Int Angiol. 2010 Jun;29(3):284-5
references: 20502418
references: Surgery. 1995 Jan;117(1):1-6
references: 7809821
references: J Vasc Surg. 1997 Nov;26(5):845-52
references: 9372824
references: J Vasc Surg. 2007 May;45(5):1080-2
references: 17466806
references: J Cardiovasc Surg (Torino). 2002 Aug;43(4):527-9
references: 12124568
references: Ann Vasc Surg. 1999 Sep;13(5):539-40
references: 10466998