Son Kuk Hui, Lee So Young, Kang Jin Mo, Choi Chang Hu, Park Kook Yang, Park Chul Hyun
Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine.
Department of Vascular Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine.
Korean J Thorac Cardiovasc Surg. 2017 Apr;50(2):133-136. doi: 10.5090/kjtcs.2017.50.2.133. Epub 2017 Apr 5.
A 27-year-old female patient was referred due to an edematous left lower extremity. Both saphenous veins had been ablated with an endovenous laser procedure used to treat varicose veins. Venography revealed that the left common femoral vein had been divided and that thrombosis was present at the site of division. No veins were available around the thighs. The patient was treated using a staged procedure. During the first stage, a ringed polytetrafluoroethylene graft was used to repair the common femoral vein, and an arteriovenous fistula was constructed from the femoral artery to the graft using a short segment of cephalic vein to increase graft patency. The edema was relieved postoperatively and the graft was patent. During the second stage, which was performed 6 months later, the fistula was occluded by coil embolization. The staged procedure described herein provides an alternative for venous reconstruction when autologous vein is unavailable.
一名27岁女性患者因左下肢水肿前来就诊。双侧大隐静脉均已通过用于治疗静脉曲张的腔内激光手术进行了消融。静脉造影显示左股总静脉已被切断，且在切断部位存在血栓形成。大腿周围没有可用的静脉。该患者采用分期手术进行治疗。在第一阶段，使用带环的聚四氟乙烯移植物修复股总静脉，并使用一小段头静脉从股动脉至移植物构建动静脉瘘以提高移植物通畅率。术后水肿消退，移植物通畅。在6个月后进行的第二阶段手术中，通过弹簧圈栓塞闭塞了瘘管。本文所述的分期手术为自体静脉不可用时的静脉重建提供了一种替代方法。
