Aneurysm Serpentine

Serpentine or diagonal aneurysm (Latin ae. serpentinum; Greek διαγώνιος παραδείσος) is a type of pathological aneurysm in the vessels. The shape is an elongated bubble, compressed from the sides: one end is widened, the other is narrow and short. Serpentine forms of aneurysm are most often located in the area of ​​the carotid ring and in the small fontanel. Superior vena cava (SVC) aneurysms rarely have a well-defined origin and a downward trajectory, but more often take on more complex geometric shapes, such as a “Louis XVI” shape. When studying angiography of the left SVC in young people who had previously identified deformities of the carotid arteries of congenital origin, the aneurysmal protrusion was presented in the form of an irregular two- and three-chamber pulsating formation. Multiple point additional diverticula or lateral subcapsular branches connecting the aneurysm with neighboring arteries gave the impression of its complex serpentine shape. The growth of the tumor in this area led to the development of obliteration of the large venous trunk at the junction of the last subclan branches, which is a “target” for traumatic bleeding. The arterial vessels passing between the sides of the aneurysmal sac were involved in the process of obliteration almost without changes, which is rare when considering pathomorphological changes in patients in the immediate postoperative period. In this case, despite the use of modern neuroimaging methods and complex endovascular correction, there is a risk of additional development of varicose segments of the SVC. The case is clear