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Lower Limb Venous Thromboembolism
Published in James Michael Forsyth, How to Be a Safe Consultant Vascular Surgeon from Day One, 2023
The case was that of an aggressive colorectal cancer that had locally invaded various structures in the pelvis. The operation involved an AP resection with removal of various pelvic structures, including the uterus, part of the bladder, ureter, and part of the lumbar spine. The internal iliac vein on the right was ligated, and there was also an injury to the right common iliac vein. There was significant bleeding secondary to this injury and the common iliac vein was repaired using some interrupted prolene stitches.
Vascular Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Yiu-Che Chan, John Wang, Julian Wong, Edward Choke, Tjun Tang
What is the role of venous stents in patients with iliofemoral DVTs?Venous stenting appears to be an effective adjunct to early thrombus removal, particularly associated May–Thurner syndrome; although stents placed for external compression have less favourable outcomes.2May−Thurner syndrome is a condition in which compression of the common venous outflow tract of the left lower extremity may cause discomfort, swelling, pain or blood clots (deep-venous thrombosis) in the iliofemoral veins. It is due to left common iliac vein compression by the overlying right common iliac artery. This leads to stasis of blood, which predisposes to the formation of blood clots.
Contemporary Outcomes after Venography-Guided Treatment of Patients with May-Thurner Syndrome
Published in Juan Carlos Jimenez, Samuel Eric Wilson, 50 Landmark Papers Every Vascular and Endovascular Surgeon Should Know, 2020
Juan Carlos Jimenez, Samuel Eric Wilson
Our manuscript included a retrospective analysis of a prospectively maintained single-center database of 102 patients with left-sided venous occlusive disease between 2008 and 2015, selecting only patients with compression of the left common iliac vein by the right common iliac artery (n = 70 patients). Excluded were other nonthrombotic iliac vein lesions such as retroperitoneal fibrosis, pelvic tumors, or other compressive syndromes.
Abdominal aortic and iliac aneurysm presented as lower limb deep vein thrombosis: case report
Published in Acta Chirurgica Belgica, 2020
Vedran Pazur, Inga Dakovic Bacalja, Ivan Cvjetko, Ana Borovecki
A 63-year old patient presented to our emergency room with right lower limb swelling and pain. There was no history of trauma or recent travel. The patient denied any prior symptoms of lower extremity claudication or vein disease. He had a history of dyslipidemia, hypertension, cerebrovascular disease, and a heart failure. His vital signs were stable. Blood pressure was 135/80 mmHg, pulse was 83/min and the RBC (red blood cell count) were normal. During the initial examination, the patient presented with a swollen right leg (both thigh and the calf) and a palpable pulsatile abdominal mass without abdominal or chest pain. A duplex ultrasound examination confirmed a DVT of the right common iliac vein. In addition, computed tomography angiography (CTA) scan of the thorax and abdomen showed an AAA 60 × 70 mm and a 22-mm aneurysm of the right common iliac artery compressing the inferior caval vein (ICV) and the right common iliac vein. The thrombosis of the ICV and the right common iliac vein resulted in the right lower extremity edema only. The circumference of the right and left thigh measured 86 and 73 cm, respectively. The right and left calf measures were 55 and 45 cm, respectively (Figure 1).
An expert spotlight on inferior vena cava filters
Published in Expert Review of Hematology, 2021
Anil Pillai, Manoj Kathuria, Maria del Pilar Bayona Molano, Patrick Sutphin, Sanjeeva P Kalva
Failure of regression of the left supracardinal vein results in duplicated IVC. The left common iliac vein continues as the left-sided IVC draining into the left renal vein which joins the right IVC and continues as the single normal suprarenal IVC. The incidence of duplicated IVC ranges from 0.2% to 3% [57]. Alternatively, the left IVC may join the hemiazygous vein. Most of the times the ipsilateral common Iliac vein drains into the ipsilateral IVC. If a duplication stays unrecognized, the incidence of recurrent pulmonary emboli is higher [56]. Multiple approaches for the insertion of an IVC filter have been described including the use of a suprarenal IVC filter, bilateral infrarenal IVC filters, and bilateral common Iliac vein filters [58,59].
Surgical aspects of venous pelvic pain treatment
Published in Current Medical Research and Opinion, 2019
S. G. Gavrilov, O. I. Efremova
Endovascular stenting of the left iliac veins is the no-alternative method for treating May–Thurner syndrome. The global experience of using iliac vein stenting in this syndrome includes more than 1000 procedures. The procedure involves endovenous balloon angioplasty followed by the installation of a self-expandable stent in the common iliac vein (Figure 5). The technical and clinical success rates of this procedure are 98–100%. Case reports about migration and stent thrombosis are extremely rare.