Surgical management of chronic venous insufficiency of lower limbs

This study included ten male patients who came to Kasr El-Eini Hospital from January 1991 till December 1991. Their age ranged from 24-46 years with mean age of 32.9 years. They presented with chronic venous insufficiency, eight of them were of post-phlebitic origin while the other two cases were of primary valvular incompetence. The surgical correlation of chronic venous insufficiency was the last station in management after exhaustion of all conservative and medical maneuvers with the following varieties: Correction of venous reflux at the level of popliteal vein alone was done in three patients [30%] in the form of competent basilic vein segment in two cases and indirect valvuloplasty [venocuff] in the other case. Correction of venous reflux at the level of popliteal vein and long saphenous vein was done in three patients [30%] in the form of competent basilic vein segment transplantation in both the popliteal vein and upper part of long saphenous vein. Correction of venous reflux at the level of common femoral vein, popliteal vein and long saphenous vein was done in one patient [10%] in the form of competent basilic vein segment transplantation at the upper part of long saphenous vein and popliteal vein. Venocuff was inserted around the refluxing femoral vein. Correction of venous reflux at the level of long saphenous vein only was done in three patients [30%] by a competent basilic vein segment transplantation

Iatrogenic vascular injury: an experience with 40 cases

Forty patients with iatrogenic vascular injury have been studied. The age ranged from 3-65 years [mean 32.8]. 60% were males and 40% were females. Half of the cases were due to operative trauma, while the other half were due to catheter injury. The first group was diagnosed by massive bleeding intraoperative in 16 cases, postoperative ischemia in 3 cases and huge hematoma in one case. In catheter group, 13 cases diagnosed by ischemia, 2 by hematoma, 2 by lost catheter tip, Fogarty catheter is responsible for 2 cases, while the last case was due to neglected tourniquet. The ratio of arterial of venous injury was 33: 1. The venous injury is mainly due to operative trauma. The common femoral vessels are the main site of injury. The main pathology was segment damage. The surgical management was according to the site, reputation and pathological changes encountered