Ultrasound assessment of the outcomes of veno-venous bypass operations in postthrombotic disease

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Abstract


Aim. Assessment of the function of veno-venous bypass operations in postthrombotic disease with the use of ultrasound duplex scanning.

Methods. The results of veno-venous bypass procedures are presented including crossover autovenous bypass for unilateral postthrombotic iliac vein obstructions (during short-term postoperative period in 56 patients, during long-term period - in 68) and saphenopopliteal bypass for femoral vein obstruction (in 12 patients).

Results. Functional tests making ultrasound duplex scanning more informative in assessment of the function of bypass operations were developed. It was determined that most of crossover grafts (70.6%) have a propensity to equal «physiological» dilation leading to the requisite venous drainage from an affected extremity. Some grafts (23.6%) undergo pathological transformations like local and diffused deformed dilation, сicatricial stenosis that diminish venous drainage and require reintervention on the graft. Venous hemodynamic studies of the affected extremity with the graft being open and cross-clamped showed that in 73% of the patients the major role in the maintenance of venous return is played by crossover bypass. Long-term outcomes in 56 patients after 15 years proved patency of crossover grafts in 43 patients (79.6%). In 11 out of 12 patients (91.7%) examined during long-term postoperative period saphenopopliteal grafts were patent. It was demonstrated that they are capable of prolonged functioning without pathological dilation. Long-term outcomes of the procedure proved reliable function of the grafts and improvement of regional venous hemodynamics.

Conclusion. Ultrasound duplex scanning is the optimal method of the assessment of short-term and long-term outcomes of reconstructive bypass operations due to their noninvasiveness, safety, and high resolving power and the possibility of repetitive qualitative and quantitative studies of venous system including those in community setting.


I M Ignat’ev

Author for correspondence.
imignatiev@rambler.ru
Interregional Clinical and Diagnostic Center; Kazan State Medical University Kazan, Russia; Kazan, Russia

E E Fomina

imignatiev@rambler.ru
Interregional Clinical and Diagnostic Center; Kazan State Medical University Kazan, Russia; Kazan, Russia

S Yu Akhunova

imignatiev@rambler.ru
Interregional Clinical and Diagnostic Center Kazan, Russia

A V Zanochkin

imignatiev@rambler.ru
Interregional Clinical and Diagnostic Center Kazan, Russia

  • Menyhei G., Szabo M., Kollar L. Late results of the Palma operation. Orv. Hetil. 1995; 136 (32): 1713-1716.
  • Зубарев А.Р., Богачёв В.Ю., Кириенко А.И. Нижняя полая вена и её ветви. В компьют. курсе: Ультразвук и сосуды: диагностическая практика. М.: МНЦ КИТ; 1999.
  • Веденский А.Н., Стойко Ю.М., Сабельников В.В. и др. Перекрёстное аутовенозное шунтирование при односторонних окклюзиях подвздошных вен. Ангиол. и сосуд. хир. 1997; (4): 11-25.
  • Harris J.P., Kidd J., Burnett A. Patency of femorofemoral venous crossover grafts assessed by duplex scanning and phlebography. J. Vasc. Surg. 1988; 8 (6): 679-682. doi: 10.1016/0741-5214(88)90074-2.
  • Schanzer H., Skladany M. Complex venous reconstruction for chronic iliofemoral vein obstruction. Cardiovasc. Surg. 1996; 4 (6): 837-840. doi: 10.1016/S0967-2109(95)00147-6.
  • Coleman D.M., Rectenwald J.E., Vandy F.C., Wakefield T.W. Contemporary results after sapheno-popliteal bypass for chronic femoral vein occlusion. J. Vasc. Surg.: Venous Lym. Dis. 2013; 1 (1): 45-51. doi: 10.1016/j.jvsv.2012.10.055.

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© 2017 Ignat’ev I.M., Fomina E.E., Akhunova S.Y., Zanochkin A.V.

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