Abstract:

Inferior vena cava (IVC) abnormalities are reported to occur in 3% of the population, and bilateral IVC is the most common one. We presented a case of a patient with bilateral IVC and pulmonary embolism threat due to deep vein thrombosis of the left leg and thrombus flotation in the left external iliac vein. Two cava-filters were placed. The need of two devices is obvious, because emboli can easily reach the pulmonary artery via either right or left IVC.

Reference

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Abstract:

Purpose: Was to observe the immediate and long-term results of hybrid operations in multilevel atherosclerotic lesions of aorto-iliac(AIS) and femoral-popliteal segments (FPS). Article describes the method of the hybrid intervention in the aorto-iliac segment

Materials and Methods: For the period of 2007-2011 - 40 patients with multilevel lesions of iliac arteries and lower limb arteries underwent hybrid operations. 57.5% of patients had aorto-iliac segment disease, classified as TASC C, and 42,5% - TASC D. Lesions of femoral-popliteal segment was divided in the following order: TASC A - 15,0%, TASC B - 35,0%, TASC C - 42,5% and TASC D - 7,5%. We applied loop endarterectomy with stenting for the correction of the aorto-iliac lesions. For arterial outflow correction we applied surgical operations. Follow-up period has been traced for 3 years.

Results: Primary technical success was achieved in 97.5%. Complications of the immediate postoperative period were noted in 15%. Long-term results were traced for 3 years in 70% of patients. Three-year assisted patency of aorto-iliac segment was 89%. All complications have been corrected only by endovascular procedure. Three-year cumulative patency of femoral-popliteal segment was 87%.

Conclusions: This technique allows achieving the best results in reducing lower limb ischemia. Simultaneous correction of both - inflow and outflow segments improved long-term results of each of the reconstruction. The method shows its effectiveness in patients with TASC C and TASC D lesions of aorto-iliac segment. Reduction of surgical trauma significantly affects the results in group of high risk patients. 

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