1/43. Temporary arterio-venous shunts to dilate saphenous crossover graft and maintain graft patency.A modification of the Palma operation is described in a 25-year-old man with impaired venous outflow of the right leg. After a phlebitic occlusion of the right superficial femoral and external iliac veins he had been operated on twice for varicose veins. The result of these operations was a serious outflow stasis of the right leg during exercise. A saphenous cross-over graft to the right popliteal vein was constructed. Preoperatively a temporary arterio-venous shunt between the left posterior tibial artery and the great saphenous vein had been made in order to increase the diameter of the saphenous vein. Three months later the dilated saphenous vein was resected at the level of the sapheno-tibial artery shunt and anastomosed to the popliteal vein of the right leg. The cross-over graft occluded several times during this operation. A temporary popliteo-popliteal arterio-venous shunt was established distally to the sapheno-popliteal anastomosis to keep the vein graft patent. This second arterio-venous shunt was resected after three months. Venography one month later showed that the vein graft was patent. The patient's complaints had disappeared one month after the operation and a normalization of his venous outflow was recorded plethysmographically. The graft has remained patent during an observation time of eighteen months.- - - - - - - - - - ranking = 1keywords = stasis (Clic here for more details about this article) |
2/43. Lipodermatosclerosis - report of three cases and review of the literature.We report 3 cases of lipodermatosclerosis (LDS) and discuss the nosology of similar disorders caused by venous insufficiency of the legs. These cases are characterized by (1) occurrence in middle-aged or aged woman, (2) painful, indurated erythema with hyperpigmented scleroderma-like hardening on the lower leg, (3) lobular panniculitis with membranocystic fat necrosis and various degrees of septal fibrosis. Although the designation LDS has been used particularly in the UK and in the USA, this entity is not familiar in other countries including japan. LDS clinically represents a wide spectrum from an acute, inflammatory phase to a chronic, fibrotic state. The clinicopathologic findings of LDS are similar or identical to the disease previously reported as chronic indurated cellulitis, hypodermitis sclerodermiformis, stasis panniculitis or sclerosing panniculitis. These diseases are probably related conditions, which depend upon the various stages.- - - - - - - - - - ranking = 1keywords = stasis (Clic here for more details about this article) |
3/43. Renal transplantation in patients with complete obstruction of the inferior vena cava.We describe 2 patients with end-stage renal disease who had complete obstruction of the inferior vena cava and were successfully treated with renal transplantation in the usual iliac fossa position. One patient is doing well, with normal renal function more than 20 years after transplantation; the other patient was lost to follow-up after 3 months. Despite some technical difficulties, these patients apparently do well provided that an adequate collateral circulation bypassing the obstruction is confirmed by venography, and the patients receive anticoagulant therapy indefinitely.- - - - - - - - - - ranking = 0.050552349723793keywords = obstruction (Clic here for more details about this article) |
4/43. Intermittent brachiocephalic vein obstruction secondary to a thymic cyst.Mediastinal thymic cysts are usually asymptomatic and found incidentally on a routine chest roentgenogram. Rarely, they may cause symptoms of vascular obstruction. A 55-year-old woman presented with intermittent swelling in her left neck. The swelling was positional and was worse while supine and disappeared while upright. Evaluation revealed a thymic cyst causing extrinsic compression of the left brachiocephalic vein. The cyst was resected with complete resolution of the left neck swelling.- - - - - - - - - - ranking = 0.042126958103161keywords = obstruction (Clic here for more details about this article) |
5/43. Salvage of right colon interposition by microsurgical venous anastomosis.venous insufficiency of a right colon interposition in esophageal reconstruction can be a fatal complication resulting in total failure. A case is presented of the salvage of the right colon interposition by additional microsurgical venous anastomosis to relieve the problem of venous stasis. The outcome was successful in a young patient with a complicated medical history.- - - - - - - - - - ranking = 1keywords = stasis (Clic here for more details about this article) |
6/43. Unrecognized internal jugular vein obstruction: cause of fatal intracranial hypertension after tracheostomy?We report an unusual case of fatal intracranial hypertension following tracheostomy due to the obstruction of the internal jugular veins (left side: thrombosis after central venous cannulation, right side: hypoplastic vein) and their collaterals. Principal cerebral outflow through the internal jugular veins can be substituted by the internal and external vertebral vein plexus because blood drains from the brain by two major routes: the internal jugular veins and the vertebral venous plexus. We suggest transcranial color-coded duplex sonography as a simple bedside method to detect patients with significant reduction of venous drainage who are at risk of developing massive cerebral venous congestion as a result of reduced intracranial elastance.- - - - - - - - - - ranking = 0.042126958103161keywords = obstruction (Clic here for more details about this article) |
7/43. Venous stasis ulcers due to primary, isolated deep venous insufficiency in a patient with systemic lupus erythematosus: report of a case.Primary, isolated deep venous incompetence is rare, difficult to diagnose, and can lead to the development of venous stasis ulcers. We herein report a case demonstrating chronic venous stasis ulcers due to primary, isolated deep venous incompetence, which was misdiagnosed as vasculitis ulcers associated with systemic lupus erythematosus (SLE). Although primary, isolated deep venous incompetence is rare, it is important to bear this possibility in mind when a patient presents with leg ulcers.- - - - - - - - - - ranking = 6keywords = stasis (Clic here for more details about this article) |
8/43. Advisability of surgical treatment for chronic membranous obstruction of the hepatic portion of the inferior vena cava.Transatrial membranotomy was performed in a patient with membranous obstruction of the hepatic segment of the inferior vena cava, manifesting as longstanding varicosity and edema of the legs, chronic type of budd-chiari syndrome, liver cirrhosis and hypersplenism. The course in this patient and similar ones reported in the literature suggests a conservative approach.- - - - - - - - - - ranking = 0.042126958103161keywords = obstruction (Clic here for more details about this article) |
9/43. A rare case of idiopathic retroperitoneal fibrosis involving obstruction of the mesenteric arteries, duodenum, common bile duct, and inferior vena cava.Idiopathic retroperitoneal fibrosis (IRF), usually affects the ureter, although the biliary tree, duodenum and vasculature may also be susceptible. This case report describes a 64-year-old man with IRF, who presented painless watery diarrhea, radiological features of obstructive jaundice and duodenal obstruction, and ultimately an obstruction of the inferior vena cava. We employed tamoxifen for his treatment, but the disease progressed and the patient died of multiple organ failure two years after the onset. While the cause of IRF in this patient was obscure, we suspected his painless watery diarrhea indicated chronic ischemia of the small bowel, and the findings of an abdominal CT scan were extremely valuable in indicating IRF.- - - - - - - - - - ranking = 0.050552349723793keywords = obstruction (Clic here for more details about this article) |
10/43. Silent unilateral pulmonary venous obstruction. Occurrence after surgical correction of transposition of the great arteries.An 11-year-old girl was found to have completely obstructed left pulmonary veins eight years following corrective surgery for transposition of the great arteries. The patient was acyanotic and asymptomatic. Retrograde flow of arterial blood from the affected left lung accounted for an angiographic appearance that mimicked occlusion of the left pulmonary artery and resulted from a failure of systemic venous development. Pulmonary venous anatomy could only be demonstrated by pulmonary arterial wedge angiographic studies. This experience emphasizes that complete unilateral pulmonary venous obstruction may occur in an asymptomatic patient and underlines the importance of investigating pulmonary venous anatomy in any patient with gross inequality of the distribution of pulmonary blood flow.- - - - - - - - - - ranking = 0.042126958103161keywords = obstruction (Clic here for more details about this article) |
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