Aneurysmal Dilatations of the Superior Vena Caval System

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Abstract
Evidence from the literature and from personal cases which appears to prove that venous aneurysms are a true entity is presented. A suggested classification has been presented. The place for venous angiomata and neoplasm in such a classification is debatable. An attempt is made to present the radiologic criteria, clinical features, and recommended therapeutic measures. Aneurysmal disease of veins is less rare than previously suspected. A useful classification has been presented whose major weakness involves the status of venous angiomata and neoplasms. Catheterization can be a specific hazard in these lesions unless such studies have been so planned as to avoid actual insertion of the catheter with the lumen of the aneurysmal vein. Roentgenographic and fluoroscopic study reveals varying findings according to the specific type of lesion being investigated. Venous aneurysms may appear vague or absent on lateral roentgenograms. Dilatation of intrathoracic veins can imitate mediastinal tumors. Final diagnosis requires venography. The clinical pictures varies markedly according to type, location, and size of the lesion. Treatment is excisional or reparative in pure primary, false venous aneurysms, and arteriovenous fistulae.