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Axillary vein transfer in trabeculated postthrombotic veins
S Raju1, P Neglén, J Doolittle
1Department of Surgery, University of Mississippi Medical Center, Jackson, USA.
Journal of Vascular Surgery
|June 9, 1999
Summary
Axillary vein transfer is a safe and effective treatment for severe postthrombotic syndrome in patients with trabeculated veins. This surgical approach offers durable results, improving symptoms like ulceration and pain.
Area of Science:
- Vascular Surgery
- Venous Disease Management
Background:
- Postthrombotic syndrome (PTS) can cause severe venous hypertension and debilitating symptoms.
- Trabeculated veins present a surgical challenge in PTS treatment.
- Aggressive surgical intervention may benefit patients with severe PTS.
Purpose of the Study:
- To evaluate the efficacy of axillary vein transfer in patients with trabeculated veins.
- To assess the success of an aggressive surgical approach for severe PTS.
Main Methods:
- 102 axillary vein transfer procedures were performed on 83 limbs with trabeculated veins.
- Combined procedures included valve repair and targeting superficial/deep femoral veins.
- 90% of limbs had venous stasis dermatitis or ulceration pre-operatively.
Main Results:
- Actuarial transplant patency was 83% at 10 years; freedom from recurrent ulceration exceeded 60%.
- Severe preoperative venous hypertension did not impact outcomes, but persistent short venous filling times post-surgery did.
- Significant reduction in swelling (55%) and pain (70%) was observed.
Conclusions:
- Axillary vein transfer is a safe, effective, and durable option for severe PTS with trabeculated veins.
- This procedure, combined with antireflux techniques, offers a viable alternative when conservative or other surgical methods fail.