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At least 19 recordsLinked to original sources
PubMedDate not supplied

[Results of vascular repairs in trauma of the femoral veins, iliac veins and the inferior vena cava].

We examined the records of 12 patients operated for lesions of the inferior vena cava, the iliac vein, or the common femoral vein were examined. The results of venous grafts, treatment of the lesions of the posterior inferior vena cava or the supra hepatic vena cava and the permeability after repair of these large vessels was studied. Treatment included simple suture (n = 9), venous patch (lateral iliac vein, n = 1), and venous autografts (common femoral veins, n = 2). For 3 lesions of the posterior or supra-hepatic inferior vena cava, haemostasis was obtain by double clamping (n = 2) or four-way clamping (n = 1) with right hepatectomy. In 9 cases, the patients were followed-up for a mean of 59 months. Morphologic exploration with phlebography (n = 1) or echo-Doppler examination (n = 7) was performed during the follow-up period. There were no post-operative deaths. There were no functional sequellae affecting the lower limbs. In one case, the echo-Doppler examination revealed repermeabilization of a thrombosed lateral iliac vein after simple suture. Lesion repair of large diameter veins with autografts using the internal jugular or internal saphenous vein gave good results. Haemostais of posterior or supra-hepatic lesions to the inferior vena cava was obtained with clamping. In cases with associated hepatic involvement, haemostasis was controlled with a four-way clamp and trans-hepatic access or digitoclasty. Long-term permeability of venous repair was good.

Abdominal Injuries↗
PubMed2003

Right internal iliac vein joining the left common iliac vein: case report demonstrated by CT angiography.

An unusual variation of the iliac veins was detected by computed tomography (CT) angiography in a 35-year-old man. In coronal CT reconstructions, it was shown that the right internal iliac vein of this patient crossed to the left side and drained to the left common iliac vein. This variation is important in retroperitoneal, laparoscopic and orthopedic surgery. We present the CT findings and discuss the embryological origin of this unusual congenital anomaly.

Adult↗
PubMedDate not supplied

Traumatic fistula between internal iliac artery and external iliac vein.

Traumatic iliac arteriovenous fistulas (AVFs) are extremely rare, with only two cases reported in literature involving the internal iliac artery and the external iliac vein. We report the case of a 23-year-old man who sustained a gunshot injury to the left lower quadrant of his abdomen and subsequently developed unilateral leg edema of "elephantiasic proportions." Intra-arterial digital subtraction angiography six years later was essential for diagnosis and comprehension of the pathomechanism. The angiographic examination showed an internal iliac false aneurysm, as well as a high-flow arteriovenous communication between the left internal iliac artery and external iliac vein complicated by thrombotic occlusion of the left common iliac vein. The initial vascular injury and the surgical management of simple ligation were thought to be responsible for the iliac AVF and the subsequent thrombosis of the common iliac vein. On the one hand, the thrombotic occlusion of proximal vein led to a sharp increase of mean pressure in the proximal and distal arteries and in the distal vein, resulting in chronic venous insufficiency with incompetent varicose veins. On the other hand, the restriction of venous outflow produced extreme peripheral edema and large superficial veins serving as collaterals to bypass the fistula. Vascular surgery could repair the lesion by closing and bypassing the AVF.

Adult↗
PubMedDate not supplied

[Treatment of iliac vein thrombosis by use of filter placed in the inferior cava vein in a female patient after reoperation of meningioma of the smaller section of the sphenoid bone].

Deep phlebothrombosis is a one of the postoperative complications in neurosurgery in 90% localized in lower extremities. The brain contains the highest concentration of tissue thromboplastin compared with the other organs. That fact plays an important roll in pathophysiology of thrombo-embolic process in neurosurgery. The most frequent places of thrombogenesis are venous sinus of soleus muscle and gastrocnemius muscle, next: deep veins of crus, femoral veins and iliac veins. We describe the case of the efficient treatment of femoral vein and iliac vein thrombosis using filter placed under control of monitor in the inferior caval vein higher than the thrombus.

Female↗
PubMed2000

Hepatic vein reconstruction by external iliac vein graft using vascular clips.

The utility of hepatic vein reconstruction following resection of segments VII and VIII plus the right hepatic vein (RHV) is still controversial. The purpose of this study was to investigate the surgical benefits of hepatic vein reconstruction using stapled vascular clips and the draining area of hepatic vein using angiographic computed tomography (CT) to determine strict indications for hepatic vein reconstruction. Five patients underwent RHV reconstruction by external iliac vein graft using stapled vascular clips (VCS clips) following resection of segments VII and VIII, regardless of whether an inferior right hepatic vein (IRHV) was present. In eight other patients CT during arterial portography (CTAP) under temporary RHV occlusion using a balloon catheter was performed to determine the drainage area of the RHV. Operating times were 240 to 400 minutes (mean 336 +/- 59 minutes), and the mean hepatic vein reconstruction time was 26 +/- 5 minutes. There were no complications related to the surgery. Follow-up examinations showed patency of the graft in all cases; three patients are still alive with long-term graft patency of 10 to 24 months. CTAP under RHV occlusion demonstrated that segment VI and part of segment V were almost hypoattenuated in cases of absent or small IRHV, although those segments were hyperattenuated in thick IRHV and RHV-IRHV communicating patients. In conclusion, this anastomotic technique using vascular clips resulted in sound patency of the graft, which was accomplished by a simple technique. Preoperative CT AP with the RHV occlusion method can be useful for determining whether hepatic vein reconstruction is necessary.

Aged↗
PubMed2004

Endovascular management of iliac vein occlusive disease.

Iliac vein occlusive disease presents with either acute or chronic symptoms, both of which can be managed with endovascular techniques. This report summarizes our experience in a small cohort of patients undergoing percutaneous treatment of iliac vein occlusive disease. Six women and one man with occlusive lesions in the iliac veins are included in this report. All patients reported leg pain and swelling, involving the right leg in one and the left leg in six. Symptoms were acute in one patient and chronic in six. Two patients presented with a chronic stasis ulcer. All patients with chronic symptoms were treated with self-expanding stents deployed across the occlusive lesion. The patient with acute symptoms was treated successfully with thrombolysis, which uncovered a fixed stenosis that was then stented. Post-procedure follow-up with duplex scanning was used for vein patency. No significant complications occurred. All patients reported symptomatic improvement, with four having complete resolution. Duplex scanning showed all treated venous segments to be patent at a mean of 12 months. Recanalization of obstructed iliac vein segments can be performed successfully and leads to improvement in pain and edema in the affected limb. Midterm patency rates are excellent.

Adult↗
PubMed2005

Diagnosis and management of iliac vein compression syndrome.

Iliac vein compression syndrome (IVCS) is the most probable cause of iliofemoral deep venous thrombosis (DVT). One half to two thirds of patients with left-sided iliofemoral DVT have intraluminal webs or spurs from chronic extrinsic compression of the left iliac vein at the crossing point of the right common iliac artery. Approximately 2% to 5% of those with chronic deep venous insufficiency of the left leg may have IVCS. IVCS occurs when compression of the common iliac vein is severe enough to inhibit the rate of venous outflow. In its more severe manifestation, IVCS is known to cause acute iliofemoral DVT. IVCS is caused by the combination of compression and the vibratory pressure of the right iliac artery on the iliac vein that is pinched between the artery and the pelvic bone. With the advent of catheter-directed thrombolytic therapy for patients presenting with iliofemoral DVT, the underlying cause has been unveiled and IVCS is gaining recognition. Patients presenting with symptoms of chronic venous insufficiency often fail conservative treatment, and because of their crippling symptoms, they may have a high rate of work absence or are on permanent disability. If IVCS can be identified as the cause and corrected, the patients' quality of life would improve. With the advent of endovascular stenting, the underlying cause can be easily corrected, and long-term patency is acceptable. Diagnosis can be made by being highly suspicious when patients present in either the acute or chronic state and selecting the best diagnostic tool to confirm the diagnosis. This article discusses the prevalence of IVCS, its significance for the affected population, and the relevance of recognition, and reviews the best methods of its diagnosis and treatment. Special emphasis is placed on diagnostic tools and their efficacy, and our results to date are reported.

Adult↗
PubMed2000

Retroaortic left renal vein joining the left common iliac vein.

Retroaortic left renal vein joining the left common iliac vein is a rare congenital anomaly in the development of the inferior vena cava. To our knowledge, only one case has been reported in the literature; however, its imaging features have never been described. A 27-year-old male presented with a 1-year history of recurrent right flank pain, dysuria, hematuria, and fever (39 degrees C). Computed tomography and MR venography showed a retroaortic left renal vein joining the left common iliac vein. We present the CT and MR venography findings and discuss their feasibility in showing this congenital anomaly.

Adult↗
PubMedDate not supplied

[Leiomyosarcoma of the great veins: a case involving the left iliac vein extending to the inferior vena cava].

Large veins LMS is a rare slow growing malignant tumor originating from smooth muscle cells of the media. The authors report a case of LMS of the left common iliac vein propagating to the Inferior Vena Cava that presented with a left femoral-iliac deep thrombophlebitis. CT scan showed an uneven solid mass approximately 5 cm large within the left side of the pelvis. The mass displaced the left iliac artery and compressed the left iliac vein without a significant cleavage surface between the mass itself and the vascular structures. Location was next to the spine, medially and anteriorily to the psoas muscle. A thrombosis could be noticed within the distal segment of the inferior Vena Cava and within the proximal segment of the left iliac vein. US scan with fine needle biopsy of the mass didn't yield significant information. At surgical exploration a neoplastic mass involving and blocking the left iliac vein was found. Veinotomy performed on the iliac vein and on the distal segment of the Inferior Vena Cava but without infiltration of the vein walls. Surgical treatment consisted of asportation of the neoplastic mass, resection of the left iliac vein and thrombectomy of the Inferior Vena Cava. Histologic examination of the operated specimen revealed a mixoid LMS with vascular origin without involvement of the surrounding lymph nodes. Absence of clinical and radiological signs of relapse eight months after surgery makes further surgical and complementary (drug- and radiotherapy) treatments currently unnecessary.

Aged↗
PubMed1978

[Replacement of the iliac veins and the infrarenal vena cava regment with heterologous grafts in animal tests (author's transl)].

A bovine collagen graft was implanted in 30 dogs for the replacement of the femoral vein, the iliac vein and the inferior vena cava. During the observation period up to 210 days six thromboses of the graft were observed. Histological results after 30 days: development of a "neo-intima" with collagen type III, originating from the anastomosis. After 90 to 210 days: Continuous endothelial layer of the graft with appearance of smooth muscle fibers in the neo-intima. From the graft bed there was found resorption of the bovine collagen and replacement by new collagen type III fibers.

Animals↗
PubMed1989

New treatment of increased venous drainage in organic impotence: ligation of internal iliac veins.

The internal iliac vein is the main confluent of the periprostatic and pudendal plexus. Therefore, it seems logical to ligate both internal iliac veins in impotent patients with increased venous drainage. The procedure was performed on 52 men and combined with ligation of collaterals to the saphenous and femoral veins in 32 of them. Erectile capacity improved in 36 patients (70%). Occasional papaverin injections and local nitroglycerin application were of help in 10 patients. Failures in 16 of 52 cases were mainly due to neurovascular lesions in diabetics.

Collateral Circulation↗
PubMed1995

Aorto-iliac aneurysms rupturing into the iliac veins.

BACKGROUND: Rupture of aorto-iliac aneurysms into the iliac veins is seldom reported in distinct series, and represents only a fraction of ruptures into the abdominal cavity. MATERIAL AND METHODS: Four cases are reported: two aortic aneurysms ruptured into the right iliac vein, one right iliac aneurysm ruptured into the right iliac vein, one right iliac aneurysm ruptured into the cava at the bifurcation, one aortoiliac aneurysm ruptured into the right iliac vein. Two patients showed severe shock at admission. Central venous pressure at operation was 43.6 +/- 26.3 cmH2O, and rapidly decreased at aortic clamping. Venous bleeding was controlled by finger compression of the iliac and caval vein and aortic graft replacement followed direct suture repair of the venous breach. De Weese caval clip was implanted twice, to prevent pulmonary embolism in severely compromised iliac veins. This series represents 1% among 373 ruptured abdominal aortic aneurysms operated on as emergencies over the same period. RESULTS: Pulmonary embolism, either paradoxical or postoperative, never occurred. Mortality rate was 25%, compared to 35% overall mortality among the whole ruptured group. The role of the site of rupture is swelling of the lower limbs is suggested, and edema can be suggestive though statistical evidence has not been achieved. CONCLUSIONS: Three concepts are stressed: early diagnosis and operation (i.e. before cardiac high output failure and shock); accurate as well as simple surgical technique; careful post-operative intensive care.

Aged↗
PubMed2004

Computed tomography findings in 10 cases of iliac vein compression (May-Thurner) syndrome.

OBJECTIVE: To present the computed tomography (CT) findings for the iliac veins of 10 patients who had left-sided lower extremity deep vein thrombosis due to iliac vein compression syndrome. MATERIALS AND METHODS: The CT findings for 10 cases of left-sided acute or chronic deep vein thrombosis caused by iliac vein compression syndrome were retrospectively evaluated. The patients were five women and five men (mean age+/-S.D., 49.9+/-15.6 years). In each patient with iliac vein compression syndrome, the diagnosis of the compression was established by venography performed during endovascular treatment. Diameter of the left common iliac vein was also measured in 14 control subjects without any lower extremity venous disease for comparison. RESULTS: In all 10 cases, CT images in the transverse plane demonstrated the left common iliac vein being compressed by the overlying right common iliac artery. The mean diameter at the origin of the left common iliac vein (3.5 mm) in patients group was much smaller than the mean diameter of the same vein (11.5 mm) in the control group (p<0.01). The mean percent stenosis of the left common iliac vein due to compression by the artery was 68%. CONCLUSION: Pelvic CT images in the transverse plane are useful for detecting iliac vein compression by the overlying right common iliac artery in patients with left-sided deep vein thrombosis. Radiologists should be aware of this imaging finding of iliac vein compression by the artery where the inferior vena cava bifurcates into the common iliac veins.

Adult↗