Venous aneurysm after deep vein thrombosis: a case report

A left femoropopliteal thrombus was diagnosed in a 68-year-old man, slightly overweight, with previous surgically treated carcinoma of the tongue, non-Hodgkin’s lymphoma in remission for approximately 15 years. The patient was treated with Edoxaban 30 mg due to the reduced glomerular filtration rate (GFR). After almost 36 months the patient returned to our observation due to pain in the left popliteal cavity. On Doppler ultrasound evaluation, a venous aneurysm (diameter >2 cm) was found. The aneurysm was partially thrombosed with a pedunculated, mobile thrombus. The patient was referred to vascular surgeons who did not recommend surgical treatment considering the high surgical risk. Considering the slight improvement in GFR (52 mL/min), the Edoxaban dose was increased to 60 mg, purified micronized flavonoid fraction was added to the therapy, the therapeutic elastic stocking was upgraded to a thigh-high one, and in subsequent follow-up, there was an increase in recanalization and stability of the thrombotic apposition after six months. In conclusion, post-thrombotic syndrome is a relatively frequent complication of deep vein thrombosis. Chronic inflammation and particular anatomical conditions can cause wall damage. Venous aneurysm is a rare but fearful complication, whose conservative treatment is preferable given the high risk and low surgical success and is based on anticoagulant therapy and elastic compression at high pressures.