[Arteriovenous sheathotomy in venous thrombosis].

BACKGROUND

The pathogenesis of branch retinal vein occlusion (BRVO) seems to differ from that of central retinal vein occlusion (CRVO). Arteriosclerotic and anatomic aspects suggest that arteriovenous crossing of vessels may play a significant role. New procedures like arteriovenous decompression have been proposed to be a suitable form of treatment.

PATIENTS AND METHODS

In a clinical trial, 12 patients with ischemic BRVO underwent surgical decompression. Strict criteria of inclusion were maintained. Arteriovenous sheathotomy (AVS) was performed 0.5 - 6 months after retinal vein occlusion. Follow up-time was 3 months. Visual acuity and incidence of typical complications after RVO were the main aspects of interest in the scientific evaluation.

RESULTS

After surgical AVS, visual acuity increased significantly from logMAR 0.74 (decimal 0.18) to 0.56 (0.32) in EDTRS charts. Surgical or early complications did not occur during the 3-month control period. Improvement of retinal blood flow during angiography was demonstrated in 75 % of the patients. In 50 % of the patients all non-perfusion areas had disappeared.

CONCLUSIONS

For patients with retinal vein occlusion, AVS seems to be a safe and feasible procedure according to the pathogenesis of branch occlusion. Our results suggest that AVS has the potential to improve visual acuity while typical complications due to surgery or vein occlusion do not occur during the first three months.