First Experience of Performing Hybrid Operations in Chronic Venous Obstructions of Iliofemoral Segments in Patients With Postthrombotic Syndrome

Abstract

Objective: To assess the first results of hybrid operations in chronic venous obstructions of iliofemoral segments in patients with postthrombotic syndrome (PTS).

Methods: Hybrid operations (open endovenectomy from the common femoral vein with arteriovenous fistula creation and iliac vein stenting) were performed in 12 patients diagnosed with PTS. All of the patients were diagnosed with severe chronic venous insufficiency. The degree of manifestations of PTS was assessed by means of the Villalta score 7 months before and after the surgical intervention. Diagnostic methods of study included ultrasound duplex scanning, magnetic resonance and/or multispiral computed venography, and contrast venography.

Results: Technical success of the procedure was 92%. The outcomes of hybrid operations after 7 months were followed up in 6 patients and in 4 patients in 3 months. Secondary patency rates of the stented iliac veins amounted to 100%. No recurrences of venous ulcers were observed. Median Villalta scores improved from 15 to 7 ( P = .012).

Conclusion: The first experience of hybrid operations for obstructive lesions of veins of the iliofemoral segments demonstrated their high efficacy and safety.

Keywords: chronic obstruction of iliofemoral veins; hybrid operations; postthrombotic syndrome.