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Tytuł:
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Endophlebectomy of the common femoral vein and endovascular iliac vein recanalization for chronic iliofemoral venous occlusion.
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Autorzy:
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Dumantepe M; Department of Cardiovascular Surgery, Acibadem University School of Medicine, Istanbul, Turkey. Electronic address: .
Aydin S; Department of Cardiovascular Surgery, Acibadem University School of Medicine, Istanbul, Turkey.
Ökten M; Department of Cardiovascular Surgery, Acibadem University School of Medicine, Istanbul, Turkey.
Karabulut H; Department of Cardiovascular Surgery, Acibadem University School of Medicine, Istanbul, Turkey.
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Źródło:
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Journal of vascular surgery. Venous and lymphatic disorders [J Vasc Surg Venous Lymphat Disord] 2020 Jul; Vol. 8 (4), pp. 572-582. Date of Electronic Publication: 2020 Jan 10.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: New York, NY : Elsevier Inc., c2013-
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MeSH Terms:
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Angioplasty, Balloon*/adverse effects
Angioplasty, Balloon*/instrumentation
Iliac Vein*/diagnostic imaging
Iliac Vein*/physiopathology
Vascular Surgical Procedures*/adverse effects
Femoral Vein/*surgery
Postthrombotic Syndrome/*therapy
Venous Thrombosis/*therapy
Adult ; Aged ; Chronic Disease ; Combined Modality Therapy ; Female ; Femoral Vein/diagnostic imaging ; Femoral Vein/physiopathology ; Humans ; Male ; Middle Aged ; Postthrombotic Syndrome/diagnostic imaging ; Postthrombotic Syndrome/physiopathology ; Quality of Life ; Retrospective Studies ; Stents ; Time Factors ; Treatment Outcome ; Vascular Patency ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/physiopathology ; Young Adult
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Contributed Indexing:
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Keywords: Deep venous thrombosis; Endophlebectomy; Iliac vein stenting; Post-thrombotic syndrome; Quality of life
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Entry Date(s):
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Date Created: 20200115 Date Completed: 20201221 Latest Revision: 20201221
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Update Code:
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20240105
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DOI:
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10.1016/j.jvsv.2019.11.008
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PMID:
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31932247
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Background: Chronic post-thrombotic occlusion of the iliofemoral veins causes significant morbidity, which can be alleviated if venous drainage is restored. We report our technique of surgical endophlebectomy and patchplasty of the common femoral vein (CFV) in conjunction with iliac vein stenting to restore venous flow from the infrainguinal venous system to the vena cava.
Methods: There were 157 patients who underwent CFV endophlebectomy combined with iliocaval recanalization. Questionnaires were completed both preoperatively and postoperatively to allow comparison. These included the Clinical, Etiology, Anatomy, and Pathophysiology clinical classification; the Venous Clinical Severity Score; the Villalta scale; the Venous Insufficiency Epidemiological and Economic Study on Quality of Life/Symptoms; and the 36-Item Short Form Health Survey quality of life questionnaire.
Results: Mean follow-up duration was 14.4 ± 2.9 months (range, 10-29 months). The mean preoperative Venous Clinical Severity Score was 15.3 ± 2.2, and this fell to 6.1 ± 1.8 after treatment (P < .001). The mean preoperative Villalta score dropped from 12.7 ± 2.6 to 6.3 ± 1.4 (P < .001). The quality of life and symptom severity scores were improved after 3 months by 17.2 points for quality of life (P < .001) and 20.5 points for symptom severity (P < .001). Primary patency was 81% (124/153) and secondary patency was 89.5% (137/153) at 12 months. Wound complications related to groin incision and lymphatic fistulas were observed in 22.8% (35/153) and 28.7% (44/153), respectively.
Conclusions: The hybrid operation of CFV endophlebectomy in conjunction with iliac vein recanalization should be considered a safe and effective treatment option in patients with severe post-thrombotic syndrome and iliofemoral veno-occlusive disease.
(Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
