August 1989

Venous Reconstruction for Iliofemoral Venous Occlusion Facilitated by Temporary Arteriovenous ShuntLong-term Results in Nine Patients

Author Affiliations

From the Second Department of Surgery, Kyushu University Faculty of Medicine, Fukuoka, Japan (Drs Okadome, Muto, Eguchi, and Sugimachi), and the Department of Surgery II, Ryukyu University Faculty of Medicine, Naha, Okinawa (Dr Kusaba).

Arch Surg. 1989;124(8):957-960. doi:10.1001/archsurg.1989.01410080093015

• In nine patients with iliofemoral venous occlusion, venous reconstructions using a temporary arteriovenous shunt were performed by open thromboendvenectomy with autogenous vein patch angioplasty in four, expanded polytetrafluoroethylene (ePTFE) bypass grafts (including two with external ring-supported ePTFE) in four, and Palma's procedure in one patient. There was an adequate function in the reconstructed venous segments in two of four who underwent thromboendvenectomy and in all four with ePTFE bypass grafting for nine months to 13 years after surgery. In those with a temporary arteriovenous shunt, prepared to maintain patency of the reconstructed venous segments, blood flow through the shunt exceeded 100 mL/min, determined by an electromagnetic flowmeter. Postoperative shunt closure was readily facilitated, using a looping technique and a 2-0 nylon. The increased blood flow through the graft made feasible by the temporary arteriovenous shunt enhanced the patency of the reconstructed venous graft and hence there was an improvement in the affected limb.

(Arch Surg 1989;124:957-960)