Abstract
ObjectivesThis study aims to review a case series of deep venous reconstruction procedures performed at one centre by a single consultant.MethodsA retrospective review of deep venous reconstruction procedures performed by a single consultant from 1994 to 2013 was carried out and all notes were reviewed for outcomes. A 58-month cumulative patency rate was calculated using Kaplan-Meier survival analysis.ResultsNineteen patients underwent deep venous reconstruction procedures including the Palma bypass, May-Husni bypass, femoral vein transposition and axillary vein transplant techniques from 1994 to 2013. Eleven patients were male and eight were female with a mean average age of 45.2 years (range 29-63). Clinical severity of disease ranged from C3 to C6, and 16 patients had a confirmed history of deep vein thrombosis. Cumulative primary patency rate for all reconstructions at 58 months was 89.5%, with two patients occluding and 17 remaining patent at last follow-up.ConclusionDeep venous reconstructions, particularly the Palma and May-Husni procedures, are feasible and can have good outcomes in patients failed by endovascular techniques and other more conservative therapies.
Highlights
Chronic venous disease (CVD) is a spectrum of clinical presentations including varicose veins and chronic venous insufficiency (CVI) [1]
Classified as primary or secondary, the former indicates that no trigger mechanism of venous dysfunction can be identified. This suggests that intrinsic biochemical and structural abnormalities of the vein walls are to blame, and is confined purely to reflux. The latter points to a triggering event as the cause of dysfunction and is most commonly due to deep vein thromboses (DVTs) causing damage to vein walls and valves, the clinical manifestation of which is known as post-thrombotic syndrome (PTS) [2]
This study aims to present a case series of deep venous reconstructions performed by one surgeon at a single centre, in order to add to the current knowledge base and inform clinicians of the potential outcomes and efficacy of this niche area of surgery
Summary
Chronic venous disease (CVD) is a spectrum of clinical presentations including varicose veins and chronic venous insufficiency (CVI) [1]. Classified as primary or secondary, the former indicates that no trigger mechanism of venous dysfunction can be identified This suggests that intrinsic biochemical and structural abnormalities of the vein walls are to blame, and is confined purely to reflux. The latter points to a triggering event as the cause of dysfunction and is most commonly due to deep vein thromboses (DVTs) causing damage to vein walls and valves, the clinical manifestation of which is known as post-thrombotic syndrome (PTS) [2].
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