[Reconstructive operations in unilateral occlusions of the iliac vein].
Analysed herein are the findings of the examination and outcomes of surgical management of 48 patients with unilateral occlusion of the iliac veins. Of these, grade I chronic venous insufficiency (CVI) was observed in 12 patients and grade II SVI in 28 subjects. Grade III CVI's with trophic ulcers were diagnosed in 8 patients. In a further eight patients, the primary cause of thrombosis had been catheterization of the femoral vein in childhood. Nine patients developed thrombophlebitis following the endured enteric fever, with four patients having developed it after an injury, four - after an operation on the abdominal cavity organs, and four - after delivery. In the rest 19 patients, we failed to reveal the cause of thrombophlebitis. The venous haemodynamics was studied by means of the following methods: Doppler ultrasonography, duplex scanning and phlebography. The latter was used by the indications, with the duplex scanning technique having proved to play the leading role. The patients with postthrombotic lesions of several segments appeared to have a severer degree of CVI. The venous circulation was more compensated in the well-developed suprapubic collateral network. The patients were subjected to two types of surgical interventions: the Palm-Esperon operation with and without the establishment of the AV fistula (26), and correction of the suprapubic collaterals (21). The indication for establishing the AV fistula was the difference of pressure in the femoral veins of not less than 50 mm Hg. The correction of the suprapubic collaterals was carried out in considerably varicose-dilated saphenous veins of the suprapubic area. Disseminated lesions of the deep veins and secondary alterations in the tibial veins were additionally managed and coped with by the appropriate correcting operations performed on the crus. Postoperative complications were observed in two (4.2%) patients: thrombosis of the femoral-iliac shunt and of the corrected suprapubic vein. Favourable outcomes were obtained in 46 (95.8%) patients.
Sultanov
D D
DD
Kamolov
A N
AN
Giiasova
P F
PF
Kurbanova
M O
MO
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007084:Iliac Vein; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D012189:Retrospective Studies; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014656:Vascular Surgical Procedures / Q000379:methods*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000601:surgery*