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Long-term Results in Nine Patients

Kenichiro Okadome, MD; Yoichi Muto, MD; Hiroshi Eguchi, MD; Akira Kusaba, MD; Keizo Sugimachi, MD

Arch Surg. 1989;124(8):957-960.

Abstract
• In nine patients with iliofemoral venous occlusion, venous reconstructions using a temporary arteriovenous shunt were performed by open thromboendvenectomy with autogenous vein patch angioplasty in four, expanded polytetrafluoroethylene (ePTFE) bypass grafts (including two with external ring-supported ePTFE) in four, and Palma's procedure in one patient. There was an adequate function in the reconstructed venous segments in two of four who underwent thromboendvenectomy and in all four with ePTFE bypass grafting for nine months to 13 years after surgery. In those with a temporary arteriovenous shunt, prepared to maintain patency of the reconstructed venous segments, blood flow through the shunt exceeded 100 mL/min, determined by an electromagnetic flowmeter. Postoperative shunt closure was readily facilitated, using a looping technique and a 2-0 nylon. The increased blood flow through the graft made feasible by the temporary arteriovenous shunt enhanced the patency of the reconstructed venous graft and hence there was an improvement in the affected limb.

(Arch Surg 1989;124:957-960)

Author Affiliations
From the Second Department of Surgery, Kyushu University Faculty of Medicine, Fukuoka, Japan (Drs Okadome, Muto, Eguchi, and Sugimachi), and the Department of Surgery II, Ryukyu University Faculty of Medicine, Naha, Okinawa (Dr Kusaba).

Footnotes
Accepted for publication Sept 9, 1987.

Reprint requests to Second Department of Surgery, Kyushu University Faculty of Medicine, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812, Japan (Dr Okadome).

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