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Iliofemoral venous obstruction

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https://www.readbyqxmd.com/read/29078244/-deep-veins-hybrid-procedure-for-treatment-of-iliofemoral-obstruction
#1
Jochen Grommes, Alexander Gombert, Mohammed E Barbati, Klaus Thilo von Trotha, Karina Schleimer, Houman Jalaie
Background Endovascular recanalisation of chronic obstruction of iliofemoral or caval veins gives very good patency. However, patency decreases if the common femoral vein and its side branches are also involved. Endophlectomy during a hybrid procedure can improve outcome and avoid early reocclusion due to restored inflow. The review presents the technical details and the published results of this technique. Results The hybrid procedure combines venous recanalisation and stent angioplasty with endophlebectomy...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29078243/-endovascular-therapy-of-chronic-venous-outflow-obstruction
#2
Michael Lichtenberg, Houman Jalaie
Current national and international guidelines recommend endovascular therapy of iliofemoral thromboses in young patients, as a treatment option to avoid the post-thrombotic syndrome. Possible techniques include endovascular local lysis therapy, as well as pharmacomechanical or purely mechanical procedures. Endovascular therapy of chronic obstruction of the inferior V. cava or pelvic veins is an effective therapy for patients suffering from post-thrombotic syndrome. If there is involvement of the V. femoralis communis, hybrid operations may be considered in which an AV fistula is formed or endophlebectomy is carried out...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29037346/contemporary-outcomes-of-elective-iliocaval-and-infrainguinal-venous-intervention-for-post-thrombotic-chronic-venous-occlusive-disease
#3
Johnathon C Rollo, Steven M Farley, Juan Carlos Jimenez, Karen Woo, Peter F Lawrence, Brian G DeRubertis
BACKGROUND: Patients with iliofemoral deep venous thrombosis are at risk for development of post-thrombotic syndrome. Iliac vein stenting has been shown to significantly improve clinical outcomes in patients with venous outflow obstruction, although many studies include a heterogeneous population with several different venous pathologic processes. Our objective was to evaluate the results of iliocaval and infrainguinal venous intervention for venous outflow obstruction due to post-thrombotic chronic venous occlusive disease...
November 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29033314/analysis-of-threshold-stenosis-by-multiplanar-venogram-and%C3%A2-intravascular-ultrasound-examination-for-predicting-clinical-improvement-after-iliofemoral-vein-stenting-in-the%C3%A2-vidio-trial
#4
Paul J Gagne, Antonios Gasparis, Stephen Black, Patricia Thorpe, Marc Passman, Suresh Vedantham, William Marston, Mark Iafrati
BACKGROUND: Selecting patients for iliofemoral vein stenting has traditionally relied on the identification and quantification of stenotic lesions with imaging such as multiplanar venography. Recently, intravascular ultrasound (IVUS) imaging has become more available. However, to date, the usefulness of these imaging modalities using the customary >50% treatment threshold for diameter (multiplanar venography) and area (IVUS) stenosis of iliofemoral veins has not been validated prospectively within the context of clinical improvement...
October 12, 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28818221/venography-versus-intravascular-ultrasound-for-diagnosing-and-treating-iliofemoral-vein-obstruction
#5
Paul J Gagne, Robert W Tahara, Carl P Fastabend, Lukasz Dzieciuchowicz, William Marston, Suresh Vedantham, Windsor Ting, Mark D Iafrati
OBJECTIVE: The Venogram vs IVUS for Diagnosing Iliac vein Obstruction (VIDIO) trial was designed to compare the diagnostic efficacy of intravascular ultrasound (IVUS) with multiplanar venography for iliofemoral vein obstruction. METHODS: During a 14-month period beginning July 2014, 100 patients with chronic Clinical, Etiologic, Anatomic, and Pathophysiologic clinical class C4 to C6 venous disease and suspected iliofemoral vein obstruction were enrolled at 11 U...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28731380/first-experience-of-performing-hybrid-operations-in-chronic-venous-obstructions-of-iliofemoral-segments-in-patients-with-postthrombotic-syndrome
#6
Anatoly Pokrovsky, Igor Ignatyev, Evgeny Gradusov
OBJECTIVE: To assess the first results of hybrid operations in chronic venous obstructions of iliofemoral segments in patients with postthrombotic syndrome (PTS). METHODS: Hybrid operations (open endovenectomy from the common femoral vein with arteriovenous fistula creation and iliac vein stenting) were performed in 12 patients diagnosed with PTS. All of the patients were diagnosed with severe chronic venous insufficiency. The degree of manifestations of PTS was assessed by means of the Villalta score 7 months before and after the surgical intervention...
October 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28647635/new-vein-compression-entities-in-patients-with-unexplained-leg-swelling
#7
Alaina Garrie, Lauren E Jones, Julia F Chen, Robert W Feldtman, Kenneth R Kollmeyer, Jasmine L Richmond, Craig A Ferrara, Pablo V Uceda, Lelesse Mocio, Samuel S Ahn
BACKGROUND: This retrospective study identifies often overlooked anatomical sites for nonthrombotic venous outflow obstruction (NTVO) in patients with unexplained lower extremity edema and pain. METHODS: We reviewed the charts of 75 consecutive patients experiencing symptoms of unexplained lower extremity edema with pain that were unexplained by ultrasound, computed tomography angiography (CTA), and magnetic resonance imaging (MRI), who subsequently underwent venography in an outpatient medical office from 2010 to 2014...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28595505/wound-complications-after-common-femoral-vein-endophlebectomy-influence-on-outcome
#8
Alexander Gombert, Mohammad E Barbati, Jochen Grommes, Ralph Lm Kurstjens, Mark Af deWolf, Cees Ha Wittens, Houman Jalaie
Introduction Venous recanalization of obstructed femoral and iliac veins is associated with good results regarding the feasibility and patency rate. If the common femoral vein with its inflow vessels is involved, open surgical desobliteration or endophlebectomy has been described as a crucial part of the intervention. However, when performing the hybrid procedure, a number of specific complications have been described. We present our results after venous recanalization including an endophlebectomy, focussing on wound complications and its impact on outcome...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28025027/catheter-directed-thrombolysis-and-pharmacomechanical-thrombectomy-improve-midterm-outcome-in-acute-iliofemoral-deep-vein-thrombosis
#9
Tzu-Ting Kuo, Chun-Yang Huang, Chiao-Po Hsu, Chiu-Yang Lee
BACKGROUND: Aggressive and early thrombus removal strategy has been widely used as a treatment for iliofemoral deep vein thrombosis (DVT). We compared the long-tem venous outcome, including postthrombotic syndrome (PTS), in patients undergoing catheter-directed thrombolysis (CDT) and pharmacomechanical thrombectomy (PMT). METHODS: From January 2009 to December 2013, 61 patients with acute proximal DVT were enrolled in this prospective study. Thirty-one patients underwent CDT and 30 patients underwent PMT, and each patient was followed for at least 2 years after treatment...
February 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/27990113/iliofemoral-venous-thrombosis-mainly-related-to-iliofemoral-venous-obstruction-by-external-tumor-compression-in-cancer-patients
#10
Tzu-Yao Liao, Hui-Ching Hsu, Min-Sheng Wen, Yu-Hsiang Juan, Yu-Hsin Hung, Chuang-Chi Liaw
BACKGROUND: To study iliofemoral venous thrombosis related to iliofemoral venous obstruction in cancer patients. METHODS: In this case series study, 829 cancer patients were surveyed for iliofemoral obstruction/thrombosis within 10 years. The criteria for inclusion were: (1) presence of unilateral lower-extremity swelling; (2) computed tomography (CT) scans showing a tumor with external compression of the iliac or femoral vein, and (3) duplex ultrasound scans showing venous thrombosis or venous flow insufficiency over a femoral vein or saphenous vein...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27987604/common-femoral-endovenectomy-in-conjunction-with-iliac-vein-stenting-to-improve-venous-inflow-in-severe-post-thrombotic-obstruction
#11
Himanshu Verma, Ramesh K Tripathi
Post-thrombotic syndrome secondary to iliofemoral deep venous thrombosis is a significant contributor to advanced chronic venous insufficiency. Iliac vein stenting is a standard procedure to treat iliocaval obstruction. In cases with obstruction extending across the groin, venous inflow for an iliac vein stent may be poor and compromise results of iliac vein stenting. Treatment options include extension of stents across the inguinal ligament that may have limitations in improving inflow only from only one vessel...
January 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27903022/-recanalization-techniques-for-venous-outflow-obstruction
#12
REVIEW
Michael K W Lichtenberg, Houman Jalaie
Deep vein thrombosis (DVT) is associated with a high cost burden for health care systems because of secondary cost intensive complications like pulmonary embolism and especially the post thrombotic syndrome (PTS). The current standard therapy of anticoagulation for DVT therapy has not changed through the years leaving patients especially with iliofemoral vein thrombus on a high-risk situation for developing PTS. Current study situation for endovascular treatment of iliofemoral DVT treatment gives a rationale for active thrombus removal using catheter directed therapy (CDT) or pharmacomechanical thrombectomy (PMT) which improves valvular vein function and luminal patency reducing the potential complication of PTS...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27789144/reappraisal-of-the-utility-of-the-tilt-table-in-the-investigation-of-venous-disease-%C3%A2
#13
C R Lattimer, E Mendoza
OBJECTIVES: Without gravity opposing drainage, most venous diseases would not exist. Therefore, manoeuvres that assess venous function should include gravity. The aim was to "dose" gravity in subjects using static positions and dynamic angulations on a tilt-table and to assess its effects with air plethysmography (APG) and duplex ultrasound over the femoral vein. METHODS: Three groups (providing n = 11 legs each) were compared. (a) A control group, without clinical or duplex evidence of venous disease...
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27250354/a-retrospective-comparison-of-ultrasound-assisted-catheter-directed-thrombolysis-and-catheter-directed-thrombolysis-alone-for-treatment-of-proximal-deep-vein-thrombosis
#14
COMPARATIVE STUDY
Vladimir Y I G Tichelaar, Ellen E Brodin, Anders Vik, Trond Isaksen, Finn Egil Skjeldestad, Satish Kumar, Nora C Trasti, Kulbir Singh, John-Bjarne Hansen
BACKGROUND: Recent studies have suggested that catheter-directed thrombolysis (CDT) reduces development of post-thrombotic syndrome (PTS). Ultrasound-assisted CDT (USCDT) might enhance the efficiency of thrombolysis. We aimed to compare USCDT with CDT on efficacy, safety, development of PTS, and quality of life after long-term follow-up. METHODS: We describe a retrospective case series of 94 consecutive patients admitted with iliofemoral or more proximal deep vein thrombosis (DVT) to the University Hospital from 2002 to 2011, treated either with CDT or USCDT...
August 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27083699/predictors-for-the-development-of-post-thrombotic-syndrome-in-patients-with-primary-lower-limb-deep-venous-thrombosis-a-case-control-study
#15
Nadeem A Siddiqui, Ziad Sophie, Farhan Zafar, Delvene Soares, Iram Naz
Introduction Post-thrombotic syndrome is a common and debilitating sequelae of lower limb deep venous thrombosis. Very little awareness is present about the risk factors and about the diagnosis, prevention, and treatment of this condition. Objective The objective of this study is to identify the predictors of post-thrombotic syndrome after lower limb deep venous thrombosis. Materials and methods A case-control study was conducted on all adult patients who were admitted with lower limb deep venous thrombosis at our institution from January 2005 to June 2012...
February 2017: Vascular
https://www.readbyqxmd.com/read/27061685/intravenous-pressure-changes-in-patients-with-postthrombotic-deep-venous-obstruction-results-using-a-treadmill-stress-test
#16
R L M Kurstjens, M A F de Wolf, H W Konijn, I M Toonder, P J Nelemans, R de Graaf, C H A Wittens
UNLABELLED: Essentials Little is known about the hemodynamic consequences of deep venous obstructive disease. We investigated pressure changes in 22 patients with unilateral postthrombotic obstruction. Common femoral vein pressure significantly increased after walking, compared to control limbs. Common femoral vein hypertension could explain the debilitating effect of venous claudication. Click to hear Dr Ten Cate's perspective on postthrombotic syndrome SUMMARY: Background Little is known about the hemodynamic consequences of deep venous obstructive disease...
June 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/26993686/endovascular-recanalization-of-iliocaval-and-inferior-vena-cava-filter-chronic-total-occlusions
#17
Andrew J Meltzer, Peter H Connolly, Nii Kabu Kabutey, Doug W Jones, Darren B Schneider
Inferior vena cava filter (IVCF) placement is associated with increased risk of deep venous thrombosis. This may result from filter obstruction by trapped emboli or in situ thrombosis of the IVCF, followed by caval thrombus propagation, and may be associated with significant morbidity. Here, we describe a technique and early results of endovascular recanalization of IVCF chronic total occlusions in five patients with complete chronic total occlusions of a previously implanted IVCF, the inferior vena cava, and the bilateral iliofemoral venous systems...
January 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26993548/calf-volume-changes-with-venous-occlusion-air-plethysmography-in-assessment-of-patients-after-deep-venous-thrombosis
#18
Christopher R Lattimer, George Geroulakos, Evi Kalodiki
BACKGROUND: This is an analysis of the hemodynamic response of post-thrombotic legs to a sustained thigh compression and quick-release maneuver. This is an integral part of the investigation of venous occlusion plethysmography that has been promoted as a way of assessing the venous return. The aim was to quantify the venous volume changes in patients after deep venous thrombosis (DVT) and to determine whether refluxing legs differed from obstructed legs. METHODS: The inflow and outflow air plethysmography tracings of 332 of 519 legs were examined retrospectively...
October 2014: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26993393/recanalization-and-stenting-of-a-post-thrombotic-iliac-vein-in-a-patient-with-beh%C3%A3-et-s-disease
#19
Christophe Seinturier, Frédéric Thony, Sophie Blaise, Gilles Pernod, Patrick Henri Carpentier
Vascular lesions are frequent in Behçet's disease, and among them, deep venous thrombosis may occur in up to one-third of patients. Treatment is based on immunosuppressive drugs in addition to anticoagulants. We report the case of a young woman who presented with an acute iliofemoral venous thrombosis. Acute treatment with endovascular thrombectomy and catheter-directed fibrinolysis failed, probably because of the inflammatory status of the vessel wall. Recanalization with stenting of the obstructed common femoral and iliac veins 1 year later was successful under immunosuppressive therapy...
July 2014: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26993383/the-incidence-of-contralateral-iliac-venous-thrombosis-after-stenting-across-the-iliocaval-confluence-in-patients-with-acute-or-chronic-venous-outflow-obstruction
#20
Xzabia A Caliste, Amanda L Clark, Adam J Doyle, John P Cullen, David L Gillespie
OBJECTIVE: Percutaneous transluminal angioplasty with stenting of the iliac veins is the method of choice to treat patients with symptomatic lower extremity venous outflow obstruction. The optimal method of performing this technique remains to be solved, however. One question in particular is that when braided stainless steel stents (Wallstents; Boston Scientific, Natick, Mass) are used, should these venous stents extend into the vena cava or should they stop short of this for fear of causing thrombosis of the patient's normal contralateral iliofemoral vein? It has been our practice to extend our venous stents significantly into the vena cava to coapt with the inferior vena cava (IVC) wall in the majority of patients with disease of the common iliac vein at the iliocaval junction...
July 2014: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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