Successful reconstruction in a patient with chronic and multisegmental venous obstruction: report of a case

We describe herein our technique of performing complex venous reconstruction for a patient with chronic, multiple, and long segmental venous obstruction from the left iliac vein to the infrapopliteal deep veins. To improve venous outflow and prevent venous gangrene caused by graft failure, we preserved the ipsilateral saphenous vein without dissection and performed complex venous reconstruction in the form of iliofemoral crossover bypass using a prosthetic graft, femoropopliteal bypass using the contralateral saphenous vein, both thromboembolectomy and venous repair of the infrapopliteal veins, and the creation of a distal arteriovenous fistula. The successful outcome of this surgery may provide some insight into the treatment of extended chronic venous obstruction.