Surgical femorocaval bypass for treating chronic iliac vein occlusion: a case report

摘要

Chronic inferior vena cava and iliac vein occlusion, caused by long-term of deep venous thrombosis, will lead to swelling of the limbs, venous claudication and intractable ulcer. However, conservative treatment is often ineffective for vein occlusion. With the development of interventional techniques, endovascular therapy has become the first choice for the treatment of vein occlusion with higher success rate and lower trauma. However, for cases those fail endovascular therapy or for segmental veno-occlusive diseases with low long-term patency rate, venous bypass might be the only option. And, design of anastomotic stoma and orificium fistulae design is crucial to the success of operation. A case of long term deep venous thrombosis patient with occlusion in bilateral iliac vein and distal inferior vena cava was admitted and treated with interventional therapy. Unfortunately, this method failed. Then, we selected reasonable anastomotic stoma and orificium fistulae and performed femorocaval bypass. The 12 month follow-up results showed that the swelling was successively relieved and the ulcer healed. This indicated that rational anastomotic stoma and orificium fistulae could guarantee the exact clinical efficacy of venous bypass and higher long-term patency rate.