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Hyperemic maximal venous outflow unmasks symptomatic lower extremity venous obstruction  David J. Paolini, MD, Linda S. Jones, RVT, Anthony J. Comerota,

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Presentation on theme: "Hyperemic maximal venous outflow unmasks symptomatic lower extremity venous obstruction  David J. Paolini, MD, Linda S. Jones, RVT, Anthony J. Comerota,"— Presentation transcript:

1 Hyperemic maximal venous outflow unmasks symptomatic lower extremity venous obstruction 
David J. Paolini, MD, Linda S. Jones, RVT, Anthony J. Comerota, MD, RVT  Journal of Vascular Surgery  Volume 48, Issue 3, Pages (September 2008) DOI: /j.jvs Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

2 Fig 1 (Top) Air plethysmography demonstrates normal venous outflow in patient at rest. (Bottom) Using postocclusive reactive hyperemia techniques on the same patient reveals abnormal venous volumes, prompting further evaluation for obstruction. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

3 Fig 2 Repeat ascending phlebography shows stenosis and a venous aneurysm in the area of previous operation. These findings were not considered significant on prior evaluation. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

4 Fig 3 PTFE bands above and below the profunda femoris vein junction restrict outflow to the entire lower extremity. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

5 Fig 4 A venous aneurysm and the first 2 cm of common femoral vein are resected and a ringed PTFE graft placed to repair the constricted segment. Descending phlebography demonstrates graft patency. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

6 Fig 5 Postoperatively, noninvasive studies demonstrate normal venous outflow volumes at rest and with hyperemia. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

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