Adams Matthew K, Anaya-Ayala Javier E, Ismail Nyla, Peden Eric K
Department of Cardiovascular Surgery, Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, TX 77030, USA.
Vasc Endovascular Surg. 2012 Oct;46(7):578-81. doi: 10.1177/1538574412454584. Epub 2012 Jul 31.
Patients with chronic occlusion of iliac veins may present with symptoms ranging from mild discomfort to severe disability, including limb swelling, venous claudication, and ulceration. Endovascular treatment has emerged as first line of interventional therapy. Surgical venous-venous bypasses for the management of these patients in the era of endovascular therapy are rarely performed. These procedures are reserved only for patients with severe symptoms and long occlusive lesions that have failed previous endovascular interventions. We present a clinical scenario involving the use of femorocaval bypass to treat an iliofemoral occlusion recalcitrant to stenting, manifesting with severe lower extremity swelling and venous claudication. The surgical bypass resulted in significant improvement in the patient's clinical status.
髂静脉慢性闭塞患者的症状表现多样，从轻度不适到严重残疾不等，包括肢体肿胀、静脉性跛行和溃疡。血管内治疗已成为介入治疗的一线方法。在血管内治疗时代，很少对这些患者进行外科静脉 - 静脉旁路手术。这些手术仅适用于症状严重且有长段闭塞病变、先前血管内介入治疗失败的患者。我们介绍一个临床病例，该病例使用股腔静脉旁路手术治疗对支架置入术耐药的髂股静脉闭塞，患者表现为严重下肢肿胀和静脉性跛行。手术旁路使患者的临床状况得到显著改善。
