[Vascular reconstruction of venous occlusion in the lower extremities. Experiences in 12 patients].
BACKGROUND
This paper describes the late results after surgical reconstruction for deep venous occlusion in the lower extremities.


METHODS
Twelve patients were treated, two women and 10 men (median age 46, range 17-66 years) over a 6-year period. Seven patients had chronic venous occlusion with venous claudication or ulcer, two had DVT with severely affected limbs, and three were reconstructed, because of tumour involvement. Externally supported ePTFE grafts were used in 11 patients and vein material in the last patient. The median follow-up period was 18 months (range 1-96 months). Evaluation of patency included clinical examination and duplex ultrasound or phlebography.


RESULTS
One patient died three weeks postoperatively of multiorgan failure. Another died one year postoperatively of pulmonary metastases from a leiomyosarcoma of the common femoral vein. At follow-up, 50% of the reconstructions had remained open for a median period of five years.


CONCLUSIONS
The results are comparable with those of the literature. The selection of patients requires, in addition to anatomic visualisation of the occluded segment, a haemodynamic demonstration of venous obstruction, i.e. by a pressure gradient across the occluded segment. Surgical reconstruction is possible in the case of a strong indication.
Baekgaard
Niels
N
Karkirurgisk afdeling B og klinisk fysiologisk/nuklearmedicinsk afdeling, Amtssygehuset i Gentofte.
Sillesen
Henrik H
HH
Jensen
Leif Panduro
LP
Lund
Jens Otto
JO
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000379:methods*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*