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Innovative use of contegra valved conduit in left iliocaval stent thrombosis

  • Suraj Wasudeo Nagre
  • Krishnarao Narayanrao Bhosle
  • Ritesh Gawali
  • Vignesh Ravikumar
Case report
  • 17 Downloads

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

PE-Pulmonary embolism PTS-Post thrombotic syndrome Contegra valved conduit 

Notes

Compliance with ethical standards

Consent

Informed consent has been obtained.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Indian Association of Cardiovascular-Thoracic Surgeons 2017

Authors and Affiliations

  • Suraj Wasudeo Nagre
    • 1
  • Krishnarao Narayanrao Bhosle
    • 1
  • Ritesh Gawali
    • 2
  • Vignesh Ravikumar
    • 2
  1. 1.Department of CVTS, Fifth FloorGrant Medical CollegeMumbaiIndia
  2. 2.Grant Medical CollegeMumbaiIndia

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