1/5. The first experience with endovascular stenting of the iliac veins in patients suffering from post-thrombophlebitic disease.This paper describes the results of the first experience with endovascular stenting of the iliac veins in patients suffering from post-thrombophlebitic disease. During 11 months, the patient with a history of segmental venous thrombosis and involvement of the left iliac veins received conservative treatment which included phlebotropic therapy and elastic compression. Despite these measures the patient demonstrated the symptoms of venous insufficiency such as edema, and pains in the left lower extremity. In addition, control ultrasonography and radionuclide examinations revealed chronic occlusion of the left iliac veins. In view of this circumstance we performed endovascular dilatation and stenting of the iliac veins. The postoperative period was uneventful. After two months the pains in the left lower extremity and its edema were fully removed. Control radionuclide phleboscintigraphy demonstrated complete patency of the left iliac veins. So, endovascular stenting is an effective and safe modality for the treatment of the occlusive forms of post-thrombophlebitic disease.- - - - - - - - - - ranking = 1keywords = venous insufficiency, insufficiency (Clic here for more details about this article) |
2/5. Chronic femoral arteriovenous fistula masquerading as the postphlebitic syndrome.A patient with a traumatic femoral arteriovenous fistula was misdiagnosed for 11 years as having "postphlebitic syndrome." angiography revealed diffuse dilatation of the veins and arteries of the right lower extremity with the iliac vein measuring 16.0 cm in diameter and the cava 6.0 cm in diameter. Operative repair of the fistula has resulted in marked clinical improvement and return of the patient to fulltime employment. A history of trauma should be sought when a patient presents with unilateral chronic venous insufficiency.- - - - - - - - - - ranking = 1keywords = venous insufficiency, insufficiency (Clic here for more details about this article) |
3/5. Occult antithrombin iii deficiency: a potentially lethal complication of the postphlebitic limb.Chronic venous insufficiency is a frequent sequel to lower extremity venous thrombosis. A relatively uncommon, but potentially lethal, cause of the thrombosis is congenital antithrombin iii deficiency. Recognition and treatment of this occult deficiency is critical. The following report describes a family treated by the authors for this problem. In one generation of nine siblings, three males had documentation of the disease with functional antithrombin III levels in the range of 50% to 60%. Before evaluation for the deficiency one female sibling died at the age of 20 years as a consequence of a proven pulmonary embolus. Antithrombin III levels in another female sibling, who was free of symptoms, were normal (80% to 120%). Four other siblings who were free of symptoms (one female, three males) refused evaluation. All three men with the deficiency had severe, chronic, bilateral, lower extremity, venous insufficiency manifested by pain, varicosities, edema, pigmentation, and ulceration. Despite chronic warfarin therapy, one experienced recurrent pulmonary embolization with eventual loss of perfusion of the entire right lung. Ascending venography in the symptomatic males with the deficiency revealed evidence of recurrent and diffuse venous thrombosis with partial recanalization. Recurrent lower extremity venous thrombosis consequent to antithrombin iii deficiency causes a particularly fulminant postphlebitic syndrome with characteristic venographic findings. Although potentially lethal if unrecognized and treated simply as venous insufficiency, chronic therapy with warfarin offers palliation and prolongs life.- - - - - - - - - - ranking = 3keywords = venous insufficiency, insufficiency (Clic here for more details about this article) |
4/5. Causalgic form of postphlebitic syndrome. A variety of reflex sympathetic dystrophy caused by acute deep thrombophlebitis.The causalgic form of the postphlebitic syndrome or reflex sympathetic dystrophy resulting from acute deep thrombophlebitis is a relatively uncommon and, unfortunately, frequently unrecognized form of the postphlebitic syndrome. The usual signs of venous insufficiency are minimal, but severe burning pain is characteristic, usually increased by dependency. The diagnosis is confirmed by phlebography and the response to a lumbar sympathetic block. A lumbar sympathectomy produces permanent pain relief.- - - - - - - - - - ranking = 1keywords = venous insufficiency, insufficiency (Clic here for more details about this article) |
5/5. A straightforward venous ulcer. Or is it?Venous ulcers are common in clinical practice. They are due to end stage skin and subcutaneous damage from sustained venous hypertension. The common cause may be post thrombotic syndrome or primary superficial venous insufficiency. This case illustrates the need to think of inherited thrombophilia as a primary cause.- - - - - - - - - - ranking = 1keywords = venous insufficiency, insufficiency (Clic here for more details about this article) |