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Common femoral endovenectomy with iliocaval endoluminal recanalization improves symptoms and quality of life in patients with postthrombotic iliofemoral.

Published byYulia Sudjarwadi Modified over 5 years ago

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Presentation on theme: "Common femoral endovenectomy with iliocaval endoluminal recanalization improves symptoms and quality of life in patients with postthrombotic iliofemoral."— Presentation transcript:

1 Common femoral endovenectomy with iliocaval endoluminal recanalization improves symptoms and quality of life in patients with postthrombotic iliofemoral obstruction  David Vogel, MD, Anthony J. Comerota, MD, Mustafa Al-Jabouri, MD, Zakaria I. Assi, MD  Journal of Vascular Surgery  Volume 55, Issue 1, Pages (January 2012) DOI: /j.jvs Copyright © 2012 Society for Vascular Surgery Terms and Conditions

2 Fig 1 A, B, and C, Preoperative venogram demonstrates extensive venous obstruction from the midthigh to the vena cava in a patient incapacitated following iliofemoral and femoropopliteal deep vein thrombosis (DVT) 7 months earlier. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Operative exposure of the common femoral vein (CFV), femoral vein (FV), saphenofemoral junction (SFJ), and origins of the profunda femoris vein (PFV). Smaller tributaries are ligated or controlled with vessel loops. Dissection is extended cephalad to under the inguinal ligament exposing the distal external iliac vein (EIV). GSV, Great saphenous vein. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

4 Fig 3 A longitudinal venotomy often incorporates the distal external iliac vein (EIV) to the proximal femoral vein. Fibrotic transformation of occlusive thrombus is observed, with a remaining core of old thrombus. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

5 Fig 4 The lumen of the external iliac vein (EIV) is noted to be diseased with the characteristic fibrous webs and synechiae. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

6 Fig 5 A, Postendovenectomy, the distal external iliac (EIV) and the common femoral vein (CFV) is cleared of obstruction, (B) with the dissection extending into the orifice(s) of the profunda venous system. PFV, Profunda femoris vein. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

7 Fig 6 A sheath is inserted into the distal common femoral vein (CFV) and secured by placing a vascular tourniquet around the distal CFV. Clamps on all branch vessels remain in place. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

8 Fig 7 Intraoperative venogram following balloon dilation and stenting shows unobstructed drainage from the common femoral vein (CFV) to the inferior vena cava (IVC). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

9 Fig 8 Following removal of the sheath, closure of the patch venoplasty is completed. The proximal femoral and saphenous veins were resected. Picture shows common femoral vein (CFV) patch extending onto the profunda femoris vein (PFV). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

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