Results of Femoro-Femoral Vein Bypass Grafting with Temporary Arteriovenous Fistula for Femoro-Iliac Venous Thrombosis: Differences between Operations in the Acute and Chronic Phases

Femoro-femoral vein bypass operation using a synthetic vascular graft with simultaneous construction of a temporary arteriovenous fistula (A-V f.) was performed in eight patients with acute femoro-iliac venous thrombosis after successful femoral thrombectomy but unsuccessful iliac thrombectomy; this operation was also performed in one patient with subacute thrombosis of the iliac vein and three patients with femoro-iliac post-phlebitic syndrome. Of the first nine patients who underwent the operation in the acute or subacute phase of the disease, the synthetic vascular grafts remained patent after closure of the A-V f. in six (66.7%), and no recurrence of symptoms was observed in any of the nine, including those in whom the graft was occluded. However, the graft remained patent in only one (33.3%) of the three patients who underwent the operation in the chronic phase and no improvement in symptoms was observed in the patients with occluded grafts. These differences in the results of bypass grafting are considered to be due to differences in the development of pelvic venous collaterals. The indications for this operation should be evaluated after close examination of the state of collateral vasculature.

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Chronic Iliac Vein Occlusion and Painful Nonhealing Ulcer Induced by High Venous Pressures from an Arteriovenous Malformation

Case Reports in Radiology ◽

10.1155/2011/514721 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Daniel P. Link ◽

Phillip J. Granchi

Keyword(s):

Lower Extremity ◽

Arteriovenous Malformation ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Femoral Vein ◽

Iliac Vein ◽

Vein Occlusion ◽

Venous Collaterals ◽

Iliac Vein Occlusion

Chronic femoral vein compression (May-Thurner Syndrome) is a known rare cause of deep venous thrombosis. Subsequent angiogenesis and the development of arteriovenous malformation (AVM) in the setting of chronic venous thrombosis is by itself a rare and poorly understood phenomenon. We report a case in which elevated venous pressures resulting from such compression appear to have resulted in the development of a pelvic arteriovenous malformation, which was further complicated by chronic, nonhealing painful lower extremity ulcers, and the development of extensive subcutaneous venous collaterals. Following successful embolization of the pelvic AVM and ablation of veins under the ulcers with laser and sclerotherapy, the patient's ulcers healed and she became pain-free.

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Thrombectomy with temporary arteriovenous fistula: The treatment of choice in acute iliofemoral venous thrombosis

Journal of Vascular Surgery ◽

10.1016/0741-5214(84)90019-3 ◽

1984 ◽

Vol 1 (6) ◽

pp. 867-876 ◽

Cited By ~ 126

Author(s):

G. Plate ◽

E. Einarsson ◽

P. Ohlin ◽

R. Jensen ◽

P. Qvarfordt ◽

...

Keyword(s):

Venous Thrombosis ◽

Arteriovenous Fistula ◽

Temporary Arteriovenous Fistula

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Thrombectomy For Ilio-Femoral Thrombosis In Fertile Women

10.1055/s-0038-1653219 ◽

1981 ◽

Author(s):

J Swedenborg ◽

A Delin ◽

M Hellgren ◽

H Jacobsson ◽

E Nilsson

Keyword(s):

Venous Thrombosis ◽

Anticoagulant Therapy ◽

Femoral Vein ◽

Iliac Vein ◽

Normal Delivery ◽

Av Fistula ◽

Contraceptive Pills ◽

Mother And Child ◽

Vein Stenosis ◽

Fertile Women

Thirteen women, age 29-48 years, with iliofemoral venous thrombosis were subjected to thrombectomy via the femoral vein, and construction of an arteriovenous fistula. Anticoagulant therapy was given from the operation and 6 months on. The AV fistula was closed after 3 months. After cessation of anticoagulant therapy the patency of the iliac vein was evaluated by plethysmography and, if this was inconclusive, by phlebography. A work-up for coagulation abnormalities was also made.All thromboses were left-sided. Several risk factors were present: pregnancy in 9 of 13 (2 early) contraceptive pills in 2 of 13, and iliac vein stenosis in 9 of 10. In 8 of 12 decreased levels of plasminogen activators were noted. Of the 9 pregnancies, three were complicated and required interruption, one was terminated by normal delivery one week before thrombectomy, two were interrupted at the time of thrombectomy, and three continued to normal deliveries several weeks after thrombectomy.No pulmonary embolism was observed. At follow up, the iliac vein was patent in eleven patients. It is concluded that the pathogenesis of iliofemoral venous thrombosis in fertile women is multifactorial, involving hormonal and mechanical components. This study draws attention to decreased fibrinolytic activity in many of the patients. Thrombectomy resulted in iliac vein patency in eleven of thirteen patients. The procedure is well tolerated by mother and child during pregnancy.

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Long-Term Results of Thrombectomy with Temporary Arteriovenous Fistula for Ileofemoral Venous Thrombosis

Phlebology The Journal of Venous Disease ◽

10.1177/026835558600100204 ◽

1986 ◽

Vol 1 (2) ◽

pp. 113-117 ◽

Cited By ~ 2

Author(s):

S. Zetterquist ◽

R. Hägglöf ◽

H. Jacobsson ◽

J. Johansson ◽

H. Johnsson ◽

...

Keyword(s):

Venous Thrombosis ◽

Arteriovenous Fistula ◽

Long Term Results ◽

Anticoagulant Treatment ◽

Venous Outflow ◽

Temporary Arteriovenous Fistula ◽

Distal Extension ◽

Valvular Insufficiency

Nineteen patients with acute ileofemoral venous thrombosis were subjected to thrombectomy with the addition of a temporary a-v fistula and anticoagulant treatment. At follow-up 3 years after surgery isotope phlebography disclosed more-or-less patent ileofemoral segments in 16 patients. The venous outflow capacity as estimated from venous emptying curves was normal in all but three totally occluded limbs, indicating an adequate collateral compensation. Foot volumetry demonstrated signs of venous valvular insufficiency, mainly in legs with a distal extension of the initial thrombosis; these patients complained of symptoms of post-thrombotic syndrome, which emphasizes the importance of early operation.

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Extensive venous thrombosis and hind-limb edema associated with adrenocortical carcinoma in a dog

Journal of the American Animal Hospital Association ◽

10.5326/15473317-35-4-306 ◽

1999 ◽

Vol 35 (4) ◽

pp. 306-310 ◽

Cited By ~ 8

Author(s):

MH Jaffe ◽

AM Grooters ◽

BP Partington ◽

AC Camus ◽

G Hosgood

Keyword(s):

Venous Thrombosis ◽

Adrenocortical Carcinoma ◽

Femoral Vein ◽

Vena Cava ◽

Iliac Vein ◽

Common Iliac Vein ◽

Abdominal Ultrasonography ◽

Mixed Breed ◽

Limb Edema ◽

The Right

A 10-year-old, spayed female, mixed-breed dog was referred for evaluation of bilateral hindlimb edema and weakness. Abdominal ultrasonography showed increased echogenicity of the lumen of the caudal vena cava from the level of the urinary bladder to the level of the cranial pole of the right kidney. Bilateral saphenous venograms displayed numerous filling defects in the caudal vena cava, right external iliac vein, right femoral vein, and the right common iliac vein. Extensive venous thrombosis was diagnosed, and the animal was euthanized. Necropsy confirmed the presence of venous thrombosis and revealed a right adrenocortical carcinoma that had invaded the caudal vena cava.

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Indications for stenting during thrombolysis

Phlebology The Journal of Venous Disease ◽

10.1177/0268355513476818 ◽

2013 ◽

Vol 28 (1_suppl) ◽

pp. 112-116 ◽

Cited By ~ 9

Author(s):

N Bækgaard ◽

R Broholm ◽

S Just

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Femoral Vein ◽

Iliac Vein ◽

Outflow Tract ◽

Venous Flow ◽

Pressure System ◽

Catheter Directed Thrombolysis ◽

Adjacent Structures ◽

Vein Segment

The most important vein segment to thrombolyse after deep venous thrombosis (DVT) is the outflow tract meaning the iliofemoral vein. Iliofemoral DVT is defined as DVT in the iliac vein and the common femoral vein. Spontaneous recanalization is less than 50%, particularly on the left side. The compression from adjacent structures, predominantly on the left side is known as the iliac vein compression syndrome. Therefore, it is essential that supplementary endovenous procedures have to be performed in case of persistent obstructive lesions following catheter-directed thrombolysis. Insertion of a stent in this position is the treatment of choice facilitating the venous flow into an unobstructed outflow tract either from the femoral vein or the deep femoral vein or both. The stent, made of stainless steel or nitinol, has to be self-expandable and flexible with radial force to overcome the challenges in this low-pressure system. The characteristics of the anatomy with external compression and often a curved vein segment with diameter difference make stent placement necessary. Ballooning alone has no place in this area. The proportion of inserted stents varies in the published materials with catheter-directed thrombolysis of iliofemoral deep venous thrombosis.

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Thrombectomy with temporary arteriovenous fistula: The treatment of choice in acute iliofemoral venous thrombosis

Journal of Vascular Surgery ◽

10.1067/mva.1984.avs0010867 ◽

1984 ◽

Vol 1 (6) ◽

pp. 867-876 ◽

Cited By ~ 12

Author(s):

G. Plate ◽

E. Einarsson ◽

P. Ohlin ◽

R. Jensen ◽

P. Qvarfordt ◽

...

Keyword(s):

Venous Thrombosis ◽

Arteriovenous Fistula ◽

Temporary Arteriovenous Fistula

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Management of Post-Traumatic Phlegmasia Cerulea Dolens via Right-to-Left Femoral Vein to Femoral Vein Bypass (Palma Procedure)

Vascular and Endovascular Surgery ◽

10.1177/1538574417729274 ◽

2017 ◽

Vol 51 (8) ◽

pp. 567-571 ◽

Cited By ~ 2

Author(s):

Anahita Dua ◽

Jennifer Heller ◽

Cheong Lee

Keyword(s):

Clinical Presentation ◽

Femoral Vein ◽

Rare Condition ◽

Operative Management ◽

Iliac Vein ◽

Venous Occlusion ◽

Diagnostic Process ◽

Vein Bypass ◽

Post Traumatic ◽

Phlegmasia Cerulea Dolens

Phlegmasia cerulea dolens (PCD) is a rare condition resulting from venous occlusion that impairs arterial flow. We report a rare case of post-traumatic PCD after ligation of the iliac vein with successful treatment by right-to-left femoral vein to femoral vein bypass using left great saphenous vein (Palma procedure). The clinical presentation, diagnostic process, and approach to management along with a literature review on the operative management of PCD are presented in this case report.

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Postpartum Hip Pain Caused by Deep Venous Thrombosis: A Case Report

10.21203/rs.3.rs-337871/v1 ◽

2021 ◽

Author(s):

Juri Teramoto ◽

Masahiko Nozawa ◽

Koichi Maeda ◽

Yuko Sakamoto ◽

Hironoi Ochi ◽

...

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Femoral Vein ◽

Vena Cava ◽

Unknown Origin ◽

Iliac Vein ◽

Hip Pain ◽

Common Iliac Vein ◽

Wide Range ◽

Enhanced Computed Tomography

Abstract BackgroundSural pain is usually the primary complaint for deep venous thrombosis (DVT). Hip pain in DVT is very uncommon. Case　summaryWe report a rare case of a young woman who complained of left hip pain and fever postpartum, and who was diagnosed with DVT. We first suspected purulent arthritis of the hip joint, and a magnetic resonance image (MRI) and enhanced computed tomography (CT) were performed. The MRI suggested DVT of the left iliac vein and the CT revealed a wide-range thrombus, which spread over the distal renal vein, femoral vein and common iliac vein to the sural vein. Treatment with insertion of a filter into the inferior vena cava (IVC) and use of an anticoagulant dissolved the thrombus.ConclusionDVT must be considered as a possibility whenever pregnant or postpartum women present with a fever of unknown origin or complain of hip pain with lower leg edema.

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SHORT-TERM LYSIS BY ULTRAHIGH STREPTOKINASE TREATMENT IN CHRONIC ARTERIAL OCCLUSIONS AND ACUTE DEEP VENOUS THROMBOSIS

10.1055/s-0038-1643035 ◽

1987 ◽

Author(s):

M Martin ◽

B J O Fiebach

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Femoral Vein ◽

Iliac Vein ◽

Total Clearance ◽

Clearance Rates ◽

Short Term ◽

Maintenance Infusion ◽

History Of ◽

Venous Thromboses

171 chronic arterial occlusions and 86 acute venous thromboses were treated by systemic ultrahigh streptokinase (UHSK) infusions. 38% of the patients were over 65, 27% over 70 years of age. The UHSK scheme consisted of a 1.5 million units SK per hour maintenance infusion over a period of 6 hours. 46% of the patients received one, 47% two, 6% three, and 1% four series (one series per day). 81% of the arterial patients had a history of less than 3 months. In 54% of the cases PTA followed UHSK treatment for dilation of a residual stenosis or removal of occlusion residues still persistent. In the venous patients the most proximal location was distributed as follows: calf veins 1%, femoral vein 57%, iliac vein 28%, subclavian vein 14%. The average thrombosis history was 8 days.Clearance rates of chronic arterial occlusionsBy setting up of sub-groups more favorable results were calculated. For exemple, a femoral occlusion group consisting of cases with a history shorter than 6 weeks and 2 or 3 calf arteries patent displayed a clearance rate of 77%, a figure much higher than the overall femoral resultClearance rates of deep venous thrombosisThe thrombosis duration played a significant role for thrombosis dissolution. The average occlusion history was 6 days in the total clearance group compared with 12 days in the unsuccessful cohort.

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