SURGICAL TREATMENT OF EXTRAVASAL COMPRESSION OF MAJOR VEINS IN CHILDREN

Abstract

Rationale : angiodysplasia may account for about 5% of all cases of vascular abnormalities. Patients with angiodysplasia of pelvis and lower limbs constitute half of the total amount of persons suffering from that disease. Patients with venous dysplasia relate to the most numerous group of those with angiodysplasia. Purpose of the study : determine basic syndromes found in extravasal compression of the venous bed in children, determine the pathogenetic value of the syndromes during formation of the venous pathology in children and adolescents and develop the treatment method of the pathology. Materials and methods : The following surgeries were performed: transposition of the right common iliac artery and balloon angioplasty in May-Thurner syndrome, formation of gonadoiliac anastomoses in phleborenohypertension, and removal of the cervical rib in venous type of the thoracic outlet syndrome (TOS). Results and their discussion : The main causes of small pelvis varices were as follows: valvular insufficiency (ovaricovaricocele and varicocele) in 2 of 3 of cases, aortomesenterial compression, in May- Thurner syndrome in 1 of 3 cases. The thoracic outlet syndrome (TOS) was found in eleven patients. Conclusions: staged balloon angioplasty combined with removal or hardening of veins can be the method of choice in patients with moderate May-Thurner syndrome. Transposition of the right CIA can be the method of choice in patients with severe May-Thurner syndrome. Gonadoiliac shunting is chosen in patients with small pelvis varices associated with mesoaortic compression. Removal or resection of the cervical rib is done in patients with the thoracic outlet syndrome due to the additional cervical rib.