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Jan Sloves: Femoral Vein Aneurysm and Chronic Venous Obstruction

Jan Sloves/LinkedIn

Oct 25, 2026, 17:43

Jan Sloves: Femoral Vein Aneurysm and Chronic Venous Obstruction

Jan Sloves, President and Consultant at Vascular Imaging Professionals LLC, reposted Francine Freitas Fernandes’s post on LinkedIn:

”A 51-year-old male with a history of DVT, PE and varicose veins presented with right lower limb pain, edema, and chronic ankle skin changes.

Duplex ultrasound revealed a fascinating combination of findings:

Proximal femoral vein aneurysm in a duplicated femoral vein measuring 3.0 by 3.1 cm in one channel.

Extensive chronic post-thrombotic changes, including partial vein wall compressibility, fibrosis, recanalization and reflux affecting both femoral venous channels.

Severe right iliac vein outflow obstruction with marked narrowing of the external and common iliac veins, chronic luminal fibrosis with recanalization.

But the key question is: why did the aneurysm develop?

Could chronic venous hypertension, impaired outflow, and altered flow distribution within the duplicated venous system have contributed to focal venous remodelling?

Or does this represent a primary venous wall abnormality coexisting with extensive post-thrombotic disease?

Although causation cannot be established from duplex findings alone, this case highlights the importance of looking beyond the aneurysm itself and evaluating the entire venous drainage pathway.

Deep venous aneurysms are uncommon but clinically important, particularly in patients with a history of venous thromboembolism. Their recognition should prompt careful assessment of morphology, intraluminal thrombus, reflux, and proximal outflow obstruction.

An intriguing case at the intersection of venous anatomy, hemodynamics, and chronic venous disease reminding us that understanding the why can be just as important as identifying the what.

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