Outlined prompted us to share twenty years of experience in the application of autovenous grafting when the occlusion of the main veins in 52 patients and to provide clinical evaluation of the effectiveness of its application in a long-term follow-up.
Men 19, women — 33. The patients were aged from 19 to 62 years, the 37 patients were in the age group from 30 years to 50 years. Disease duration since the onset of acute thrombosis before performing reconstructive surgery was under 1 year — for 13 patients, from 1 year to five years — 22, from 6 to 10 years 6 more than 10 years — 11. Thus, our patients venous plasty was performed after complete subsiding of acute inflammation, when there was complete clot formation and the formation of the main ways of collateral outflow.
All patients underwent measurement of venous pressure in the distal limbs and thorough phlebotonometry study, which allowed to determine the level and extent of occlusion of the main vein deep and choose the best type of plastics vessel.
Indications for restorative and reconstructive operations we considered (a) increased venous pressure more than 150 mm water. article distal to the blockage of veins b) the presence of segmental occlusion of the main vein with good patency of the proximal and distal segments of the vessel in the) presence of main saphenous vein for use as a plastic material.
The most frequently (41) graft served as the site of the great saphenous vein taken from the thigh of a healthy limb, and only 11 patients for bypass surgery used the external jugular vein. Of this number, autovenous bypass surgery on the leg was performed in 42 patients.
In connection with small diameter graft and insufficient flow rate of the anastomosis, distal to the occlusion of the main vein (iliac, subclavian, femoral), put type the jaws of a Cobra, or in an oblique direction at an angle of 45-60° to the axis of the vessel. This is because the shunt has been growing over time and corresponds to the diameter of the wider anastomosis.
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