scholarly journals Reconstruction of venous outflow after inadvertent stripping of the femoral vein

1995 ◽  
Vol 10 (2) ◽  
pp. 253-255 ◽  
Author(s):  
Vojko Flis
Keyword(s):  
Femoral Vein ◽  
Venous Outflow

Pysiological Evaluation of Venous Obstruction in the Post-Thrombotic Leg

1989 ◽  
Vol 4 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Henrik Åkesson ◽  
Lars Brudin ◽  
Ragnar Jensen ◽  
Per Ohlin ◽  
Gunnar Plate
Keyword(s):  
Clinical Symptoms ◽  
Femoral Vein ◽  
Venous Pressure ◽  
Reference Method ◽  
Iliac Vein ◽  
Venous Obstruction ◽  
Venous Outflow ◽  
Physiological Importance ◽  
Venous Outflow Obstruction ◽  
Additional Value

The accuracy and value of occlusion plethysmography (OP) in assessing post-thrombotic iliac and femoral vein obstruction was determined in 45 patients (85 legs) six months after an acute iliofemoral venous thromboses using contrast phlebography (CP) as reference method. The additional value of femoral venous pressure (FVP) measurements in assessing the physiological importance of iliac vein obstructions was determined in 34 of these patients (60 legs). The sensitivity and specificity of OP in detecting femoral and iliac vein obstructions was 79% and 84% respectively. OP was unable to distinguish femoral from iliac lesions and stenosis from obstructions. A maximum venous outflow (MVO) <30 ml·100 ml−1 ·min−1 was greatly associated with venous obstruction which was very uncommon if the MVO >50 ml·100 ml−1 ·min−1. Resting FVPs were of little value in assessing iliac venous outflow. Exercise pressures and comparison with normal contralateral veins improved the association with anatomical obstruction. A difference in FVP change with exercise exceeding l mmHg as compared to the contralateral leg was most predictive of an iliac vein obstruction. Patients with obvious clinical symptoms of venous outflow obstruction (venous claudication) all had iliac vein obstruction, abnormal OP and an FVP change with exercise exceeding 5 mmHg. This demonstrates the ability of OP and FVP to reflect physiological rather than morphological post-thrombotic venous obstruction.

Novel treatment of a totally occluded venous outflow tract of an arteriovenous graft

2018 ◽  
Vol 20 (3) ◽  
pp. 333-336
Author(s):  
Crystal A Farrington ◽  
Ahmed K Abdel-Aal ◽  
Ammar Almehmi
Keyword(s):  
Blood Flow ◽  
Chronic Total Occlusion ◽  
Femoral Vein ◽  
Chronic Hemodialysis ◽  
Outflow Tract ◽  
Arteriovenous Graft ◽  
Initial Attempt ◽  
Venous Outflow ◽  
Total Occlusion ◽  
Vein Access

Introduction: Conventional guidewire techniques are not always sufficient to restore arteriovenous graft patency in patients with challenging vascular scenarios. We discuss a novel approach to the treatment of chronic total occlusion of the venous outflow tract to enable successful arteriovenous graft thrombectomy. Case presentation: A 28-year-old female with end-stage renal disease on chronic hemodialysis and recurrent arteriovenous graft thromboses presented with a clotted thigh graft. An existing ipsilateral common femoral vein stent was found to be chronically occluded, causing persistent venous outflow obstruction and rendering an initial attempt at thrombectomy unsuccessful due to wire buckling and the inability to navigate through the stent chronic total occlusion. Results: After establishing femoral vein access, a vibrational recanalization device was used to cross the occluded stent. The device was then removed, permitting routine angioplasty. Post-angioplasty angiogram revealed persistent intra-stent stenosis, so a covered stent was deployed with good angiographic results. Routine pharmaco-mechanical thrombectomy of the arteriovenous graft was then performed. Two additional stents were placed due to stenotic recoil in the venous limb of the graft. Angioplasty was also performed at the arteriovenous graft arterial anastomosis. Repeat imaging demonstrated marked improvement in the graft blood flow. Discussion: Total occlusion of the venous outflow tract prevents adequate blood flow through an arteriovenous graft and undermines successful thrombectomy. We describe the use of the Crosser vibrational recanalization device for the safe and effective treatment of a chronic total occlusion of the venous outflow tract, thus extending the life of the patient’s vascular access for hemodialysis.

scholarly journals Living donor liver transplantation for Budd‒Chiari syndrome with right posterior segment graft and patch plasty using the superficial femoral vein: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Norikazu Une ◽  
Kazuaki Tokodai ◽  
Norifumi Kanai ◽  
Yoshikatsu Saitoh ◽  
Mineto Ohta ◽  
...  
Keyword(s):  
Femoral Vein ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Donor Liver ◽  
Venous Outflow ◽  
Superficial Femoral Vein ◽  
Donor Liver Transplantation ◽  
Chiari Syndrome ◽  
Hepatic Venous Outflow ◽  
Patch Plasty

Abstract Background In living donor liver transplantation (LDLT) for patients with Budd‒Chiari syndrome (BCS), there are several concerns about reconstruction of the inferior vena cava (IVC) and hepatic veins. Herein, we report the case of a patient with BCS who underwent LDLT with right posterior segment graft (RPSG) and patch plasty for reconstruction of the hepatic venous outflow, using the patient’s own superficial femoral vein (SFV). Case presentation A 19-year-old man, who was diagnosed with primary BCS, underwent LDLT. His main hepatic veins were totally obstructed, and membranous stenosis was seen in the IVC. The LDLT donor was his mother; however, liver volumetric analysis showed that only her RPSG was appropriate. In the recipient surgery, 16 cm of the left SFV was harvested and was cut longitudinally and opened. The right hepatic vein (RHV) of the RPSG was anastomosed to the sidewall of the SFV graft. After explantation of native diseased liver was completed, the stenotic and thickened wall of the IVC was widely resected, and a large anastomotic orifice was created. Patch cavoplasty was performed with the RHV‒SFV graft patch. After portal reperfusion started, hepatic venous outflow was satisfactory, and there was no venous graft congestion. Both his postoperative course and his long-term course after discharge were uneventful. Conclusions In LDLT for BCS patients, ingenuity is required for the reconstruction of venous outflow. The SFV patch can be safely harvested from liver transplant recipients and is suitable for venous reconstruction. In addition, RPSG is an alternative type of liver graft for LDLT if a conventional right- or left-lobe graft cannot be used.

scholarly journals VENOUS OUTFLOW AFTER HARVESTING OF FEMORAL VEIN FOR RECONSTRUCTION OF AORTOILIAC SEGMENT

2016 ◽  
pp. 25-28
Author(s):  
A. A. Lyzikov
Keyword(s):  
Femoral Vein ◽  
Limb Ischemia ◽  
Late Complications ◽  
Additional Treatment ◽  
Point Of View ◽  
Venous Outflow ◽  
Initial Surgery ◽  
Surgery Department ◽  
Aortoiliac Reconstruction ◽  
Vein Harvesting

Objective: to define the state of venous outflow after femoral vein harvesting for aortoiliac reconstruction. Material and methods. The distant results of 22 aortoiliac reconstructions with deep femoral veins performed at Gomel Regional Vascular Surgery Department over 2010-2015 have been studied. 5 patients were operated for late complications (false aneurisms) of previous aorto-femoral bypass, 8 patients were treated for acute prosthetic infection and 9 patients underwent initial surgery for terminal stage of critical limb ischemia. Results and discussion. The group of the patients after initial reconstructions revealed significant edema and lymphorea immediately after the surgery. It was not necessary to perform fasciotomy in all the cases. There were no signs of chronic venous insufficiency in all the patients in the remote postoperational period. Conclusion. The application of femoral vein for aortoiliac bypass is safe from the point of view of venous morbidity. Outflow disturbances were transient in all the cases and no additional treatment was needed.

Managing Chronic Iliac Venous Occlusions That Extend Below the Inguinal Ligament

2018 ◽  
Author(s):  
Roshni A. Parikh ◽  
David M. Williams
Keyword(s):  
Quality Of Life ◽  
Saphenous Vein ◽  
Femoral Vein ◽  
Inguinal Ligament ◽  
Venous Obstruction ◽  
Venous Outflow ◽  
Saphenofemoral Junction

This chapter describes the management, applications, challenges, and potential complications when venous occlusions extend below the inguinal ligament. Recanalization of a chronic iliocaval occlusion in combination with anticoagulation can significantly improve a patient’s quality of life. The success of treating iliocaval venous obstruction, however, depends on good venous inflow. Without adequate venous inflow, the outflow stents will fail. Evaluation of the saphenofemoral junction, femoral vein confluence, and/or saphenous vein, recanalization of the occluded segments, and extension of the stents will improve the venous inflow. This chapter describes the steps involved in the evaluation of both venous outflow and venous inflow and the establishment of flow throughout.

Placement of closed-cell designed venous stents in a mixed cohort of patients with chronic venous outflow obstructions – short-term safety, patency, and clinical outcomes

VASA ◽  
2018 ◽  
Vol 47 (6) ◽  
pp. 475-481 ◽  
Author(s):  
Michael Lichtenberg ◽  
Frank Breuckmann ◽  
Wilhelm Friedrich Stahlhoff ◽  
Peter Neglén ◽  
Rick de Graaf
Keyword(s):  
Clinical Outcome ◽  
Femoral Vein ◽  
Clinical Severity ◽  
Symptom Improvement ◽  
Venous Outflow ◽  
Stent Patency ◽  
Safety Issues ◽  
Closed Cell ◽  
Venous Clinical Severity Score ◽  
Vein Segment

Abstract. Background: To evaluate the performance of a closed-cell designed venous stent for the treatment of chronic ilio-femoral venous outflow obstruction (VOO) in the shortterm. Patients and methods: Safety, stent patency and clinical outcome after placement of the Vici Venous Stent® in patients with chronic ilio-femoral venous obstruction were assessed retrospectively. Stent patency was evaluated by duplex ultrasound scanning, and clinical outcome was determined using the revised Venous Clinical Severity score (rVCSS). Results: 75 patients (49 % female; median age 57 years; 82 limbs) with symptomatic significant VOO had stents placed in the ilio-femoral veins. Lower limb venous skin changes including ulcers (C-class in CEAP 4–6) were found in 31 patients (41 %). Nonthrombotic iliac vein lesions (NIVLs) and post-thrombotic obstruction (PTO) were found in 40 and 42 limbs, respectively. There were no safety issues. Cumulative primary, assisted-primary, and secondary stent patency in the entire cohort at 12 months were 94 %, 94 % and 96 %, respectively. Five limbs presented with stent occlusion. Two limbs had no intervention, 2/3 remained patent after reintervention. Clinical improvement (a decrease ≥ 2 rVCSS points) was observed in 81 %, 81 %, and 77 % of patients at 1 month, 6 months, and 12 months, respectively. There was a marked drop in the frequency of more marked pain and swelling (VCSS ≥ 2) from 62 % to 5 % and 93 % to 19 %, respectively. Four limbs had venous ulcers, three healed during the follow-up. Cumulative pri- mary stent patency at 12 months was 100 % and 87 % in patients with NIVL and PTO, respectively (p= 0.032). There was no statistical difference in clinical outcome between these subgroups. Conclusions: The Vici Venous Stent® placed in the ilio-femoral vein segment in patients with symptomatic VOO revealed no safety issues, had excellent primary patency and substantial symptom improvement. Long-term studies are needed to evaluate the durability of this stenting procedure.

Proximal deep venous thrombosis following PTA of the superficial femoral artery – an obligation to disclose a complication that is rarely taken into account

VASA ◽  
2006 ◽  
Vol 35 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Klein-Weigel ◽  
Pillokat ◽  
Klemens ◽  
Köning ◽  
Wolbergs ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Rare Complication ◽  
Femoral Vein ◽  
Vein Thrombosis ◽  
Explicit Information ◽  
Life Threatening ◽  
Legal Consequences

We report two cases of femoral vein thrombosis after arterial PTA and subsequent pressure stasis. We discuss the legal consequences of these complications for information policies. Because venous thrombembolism following an arterial PTA might cause serious sequel or life threatening complications, there is a clear obligation for explicit information of the patients about this rare complication.

Sign in / Sign up

Export Citation Format

Share Document