Effect of contralateral saphenous vein bypass in the treatment of chronic femoral vein obstruction / 国际外科学杂志

ABSTRACT

Objective To study the feasibility and practicability of contralateral saphenous vein bypass in the treatment of chronic femoral vein obstruction.Methods A retrospective analysis was consisted of 33 patients who received contralateral great saphenous vein bypass during the period of June 2013 to June 2017 in the Deperrtment of Biloary Vascular Surgery of Shengjing Hospital of China Medical University.All patients after operation were followed up of 2 months deadline to August 2017 by telephone or outpatient,the follow-up content including lower limb activity after resting and subjective sensation,lower limb swelling degree and so on.The measurement data was expressed by mean standard deviation ((x) ± s),paired samples t test was used for comparison among groups.Linear correlation coefficient was used to describe the difference between ankle circumference and the time to maintain anticoagulation therapy after acute thrombosis,then we explored the effect and advantages of this surgical methods.Results Compared with the preoperative index,the activated partial thromboplastin time [(21.93 ± 3.36) svs(18.11 ±2.24)s,P＜0.05],the thrombus elastic map R value[(5.45 ±0.73)min vs(4.20 ± 0.39) min,P ＜ 0.05],the D-dimer [(3 502.79 ± 4 028.02) μg/L vs (5127.76 ± ± 4722.42) μg/L,P ＜ 0.05] and the ankle circumference [(22.23 ± 1.28) cm vs (25.38 ± 0.78) cm,P ＜ 0.05] were improved,and the prothrombin time [(12.63 ± 1.74) s vs (12.32 ± 1.14),P ＞0.05] showed no difference before and after the operation (P ＞ 0.05).With the extension of time,the effect of bypass on the treatment of lower limb edema weakened.Postoperative follow-up indicated that 33 cases of patients were unobstructed and returned to normal state,21 cases could tolerated normal physical activity and had no or mild swelling,12 cases occasional had moderate swelling while the swelling could disappear after lying down for a rest,symmetric of double lower limbs in all patients returned to acceptable degree and did not affect the clothing or appearance.Conclusion The contralateral saphenous vein bypass operation has better effect and less trauma,it can improve the lower limb edema and endogenous coagulation system of chronic obstructive iliac vein disease,and the effect is better after conservative treatment for half a year.