For prevention of thrombosis pay great attention to atraumatic technique of anastomosis, the mapping of the edges of the intima and postoperative anticoagulant therapy for 5-7 days.
In 28 patients with occlusion of the iliac veins was surgery performed Palma. When observed in the long-term more than 5 years effect is not obtained only in 7 patients. Three women suffered in the subsequent pregnancy and childbirth with almost complete clinical recovery. In 4 patients with segmental occlusion of the femoral vein for the first time in our country was imposed sapheno-popliteal anastomosis, which combined with subfascial ligation of communicating veins in Linton.
We all obtained a favorable result and complete rehabilitation. Finally, 11 patients with occlusion of the subclavian vein bypass grafting performed external jugular vein on the leg with the axillary vein. Good results were obtained in 8 and without effect — 3 people.
In segmental thrombosis of the external iliac vein (mainly due to iatrogenic injury) 5 observations made late thrombectomy and plastic wall of the vessel in the form of a patch and the 4 — segment resection of the vein with a complete replacement of the arteriovenous graft (length from 8 to 14 cm type of end-to-end. Good and satisfactory results were observed in 6 of them and 3 were clear signs of rethrombosis.
When monitoring patients in the follow up period three patients after surgery Palma came apparent thrombosis of the shunt in her pubic area, associated with a late injury, two observations emerged trophic ulcers in the lower leg. In 7 patients good function of shunt, re-confirmed phlebotonometry research.
In General, despite the fact that 18 patients in the follow up period was noted passing swelling of the limb on the affected side, satisfactory results were achieved in 35.
Conservative therapy of thrombosis of the iliac and deep veins in the lower extremities almost every third patient ends with the formation of cicatricial occlusion of the vessel lumen.
Autovenous plastic with post-thrombotic ablations of the main veins allowed us to obtain positive results from 67.3 per observation.
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