Page 79 - Virtual Vascular Vol 15

Retained vein sheath.mp4

62 year old lady with an incidental finding of a
A small (1cm diameter) right renal artery saccular
aneurysm near the hilum. These are increasingly
detected due to liberal use of CT scan in medical prac-
tice. If asymptomatic the threshold of intervention is
A CT scan confirmed the findings (although not necessary). Removal of the sheath
2cm (or larger), and smaller aneurysms can be safely
may not be needed as the patient was asymptomatic. The shea
observed. First line treatment is generally coil emboli-th can be adherent
to the vein wall and forceful removal may cause venous injury, bleeding, or deep
zation.
vein thrombosis. This has to be balanced with the long term risks of infection, ve-
nous thrombosis, and migration.

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