Jugular venous aneurysms: when and how to operate.

Background: Jugular venous aneurysms are rare, usually congenital, and present particular problems in management. Whether to perform surgery or not is controversial, cosmetic considerations being the primary factor in the decision.

Methods: Over the past nine years, 10 patients with unilateral jugular venous aneurysms have been closely followed up in our department. The most informative diagnostic procedure for the condition was considered to be ultrasonographic imaging after a positive Valsalva manoeuver, but in six cases phlebography was necessary. Various operative techniques were used--venous ligation, tangential venorrhaphy with or without aneurysm resection and autovenous banding, according to the pathological findings.

Results: No complications from the surgery were reported. Over a follow-up period ranging from six months to eight years both operated and non-operated patients were found to be doing equally well.

Conclusions: Problems with the terminology of the disease, its diagnosis and the indications for surgery are discussed. Surgical methods are reviewed and a new operative technique is presented. We conclude that apart from cosmetic considerations, thrombosis and aneurysmal expansion are the principal indications for surgery.