Complex Left Profunda Femoris Vein to Renal Vein Bypass for the Management of Progressive Chronic Iliofemoral Occlusion

Left Common Femoral to Right Common Iliac Venous Bypass Through a Retroperitoneal Exposure

“…In the case here presented, the patient had a history of extensive DVT. It has been reported that only 20%–30% of iliac vein thrombi fully recannalyze with anticoagulation therapy [9]. Patients with ulcers greatly benefit from interventions to recannalyze venous obstruction improving their quality of life [10].…”

“…There are 2 main types of treatments for chronic venous obstruction; endovascular therapy and open surgical venous reconstruction. Endovascular treatment is considered the method of choice in proximal and short iliofemoral obstruction because this is a safe and minimally invasive technique [6,9]. In a study performed by Neglén et al [11] in which his group studied a total 982 limbs that had been endovascularly treated for chronic lesions in the femoroiliocaval system, the authors found that primary patency and secondary patency were 67% and 93%, respectively after 72 months of follow-up.…”

“…In a study performed by Neglén et al [11] in which his group studied a total 982 limbs that had been endovascularly treated for chronic lesions in the femoroiliocaval system, the authors found that primary patency and secondary patency were 67% and 93%, respectively after 72 months of follow-up. Furthermore, it has been reported to have better results when used to treat non-thrombotic venous obstruction while being expensive and less successful if used in patients with long femorocaval or iliocaval obstructions [9,10]. For some patients open surgical or hybrid reconstructions are the optimal option of treatment.…”

“…Jost et al [8] reported in 2001 acceptable secondary patency rate of 13 iliocaval bypass grafts at 2 years of 54% also 64% of patients noted clinical improvement demonstrating that venous graft bypass is feasible, secure and adequate. The use of an arteriovenous fistula is still controversial, some arguing better graft flow and others worse survival [8,9]. Graft surveillance should be done with duplex ultrasound at 3, 6, and 12 months postoperatively and then every 6 months for life [8].…”

Diagnosis and Treatment of Lower Extremity Deep Vein Thrombosis: Korean Practice Guidelines

“…Complex occlusion of the IVC and iliofemoral veins can lead to PTS. Anaya-Ayala et al [216] reported a case of complex venous outflow reconstruction related to chronic occlusion of the left iliofemoral vein after failed endovascular interventions. Khanna and Singh [217] suggested that open procedures should be performed in cases of unsuccessful stenting attempts, stent failure, and long occlusions in which stenting may not be feasible.…”