Brachiocephalic vein aneurysm: a systematic review of the literature

Brachiocephalic vein aneurysms are rare lesions with only 36 cases reported in the literature. They usually present incidentally as mediastinal widening on chest X-ray, with thromboembolism or mass effect on adjacent structures, or rupture. Imaging is usually sufficient to identify and characterize the aneurysm, however, certain diagnostic pitfalls can lead to misinterpretation and misdiagnosis. Exploratory surgery is sometimes needed to confirm diagnosis. Brachiocephalic vein aneurysms have been treated both conservatively with watchful waiting, antithrombotic therapy or anticoagulation as well as surgically depending on patient presentation and aneurysm characteristics. Endovascular treatment is also becoming a therapeutic option. Prognosis following surgical treatment is excellent with no reported cases of recurrence. The present systematic review aims to describe the etiology, clinical presentation, diagnosis, management and outcomes of brachiocephalic vein aneurysms.