[Possibilities of surgical treatment of the postthrombotic syndrome (author's transl)]

5% of the working population of the Federal Republic of Germany are suffering from a postthrombotic syndrome. Reconstructive venous surgery is only beginning to make progress as regards technique and number of cases. Over a period of four years and among a total of 2,000 cases of vascular surgery, there were only 112 operations on the venous system. Unilateral occlusions of the iliac vein are reconstructed by Palma Operation. The results of such interventions can be improved by creating a temporary arteriovenous fistula (14 observed cases, 12 of them functionning). In cases of thrombotic occlusion of the femoral vein, the equilateral saphenous vein can be implanted into the popliteal vein, thus providing an unimpaired runoff for the pump of the calf muscles (May-Operation). In this procedure, better haemodynamic conditions for the permeability of the graft can also be created by a temporary arteriovenous fistula established between the distal saphenous vein and the posterior tibial artery behind the ankle (9 observed cases, 8 of them functionning).