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Case Reports
. 2018 Jul;34(3):398-401.
doi: 10.1007/s12055-017-0593-z. Epub 2017 Sep 30.

Innovative use of contegra valved conduit in left iliocaval stent thrombosis

Suraj Wasudeo Nagre  1 , Krishnarao Narayanrao Bhosle  1 , Ritesh Gawali  2 , Vignesh Ravikumar  2
Affiliations
Case Reports

Innovative use of contegra valved conduit in left iliocaval stent thrombosis

Suraj Wasudeo Nagre et al. Indian J Thorac Cardiovasc Surg. 2018 Jul.

Abstract

Thrombosis of an iliofemoral vein accounts for 25% of all lower extremity deep vein thrombosis (DVT) and is associated with an increased risk of pulmonary embolism (PE), limb malperfusion, and post-thrombotic syndrome (PTS). Endothelial injury, hypercoagulability and stasis constitute Virchow's triad of thrombogenesis. Common predisposing conditions include the postoperative state, prolonged immobility (e.g., travel, hospitalization), malignancy, pregnancy, and inherited hypercoagulable conditions. Long-term complications of DVT include persistent lower extremity edema, venous claudication, hyperpigmentation, and ulceration-collectively called as PTS and are associated with a reduced quality of life with increased health care expenses. The indications for open surgical revascularization are rare and usually reserved for patients whose symptoms are refractory to anticoagulation and endovascular treatment. Here, we report a successful decompression of severe venous edema of left lower limb post left iliocaval stent thrombosis in a 50-year-old female patient. We used two contegra valved conduits which were sutured end to end with each other in the same direction as a bypass graft. Proximal end of the conduit was anastomosed to left common femoral vein and the distal end to the distal inferior vena cava (IVC). It provided prompt and effective venous outflow with complete resolution of the venous edema of left lower limb. computed tomography (CT) venogram done after 3 months of surgery showed patent contegra valved conduit with thrombosed iliocaval stent.

Keywords: Contegra valved conduit; PE-Pulmonary embolism; PTS-Post thrombotic syndrome.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
a Preopt left lower limb edema. b Postopt decreased left lower limb edema
Fig. 2
Fig. 2
a End to end unidirectional suturing of contegra conduits. b Distal end of contegra conduit anastomosed to distal IVC
Fig. 3
Fig. 3
a Contegra conduit routed from distal IVC to left common femoral vein after cutting the inguinal ligament. b Post opt CECT showing contegra conduit from left common femoral vein to distal IVC with blocked iliocaval stent
See this image and copyright information in PMC

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