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The May-Husni Procedure: A Reappraisal
E Shaydakov1, O Porembskaya1, G Geroulakos2
1Institute of Experimental Medicine for Research and Clinical Work, Clinic of Russian Academy of Medical Sciences, St. Petersburg, Russia.
Summary
The May-Husni procedure offers significant symptom relief for select patients with severe post-thrombotic syndrome due to femoral vein obstruction. Further research is needed to refine patient selection criteria for this venous bypass surgery.
Area of Science:
- Vascular Surgery
- Vascular Medicine
- Interventional Cardiology
Background:
- The May-Husni procedure, a saphenofemoral venous bypass, is infrequently used due to limited patient numbers and undefined selection criteria.
- Few institutional series document the efficacy of this surgical technique for post-thrombotic venous obstruction.
Purpose of the Study:
- To present the author's experience with the May-Husni procedure.
- To critically review existing literature on saphenofemoral venous bypass for femoral vein obstruction.
Main Methods:
- A 13-year study of 12 patients (median age 57) with severe leg symptoms underwent the May-Husni procedure.
- All patients had imaging-confirmed segmental femoral vein obstruction and poor deep femoral vein inflow.
- Ten patients were followed for a median of 60 months post-procedure.
Main Results:
- The saphenopopliteal bypass remained patent in all reviewed patients.
- Clinical improvements included resolution of venous claudication, improved hyper-pigmentation, and pain relief.
- Two patients experienced symptom recurrence due to femoral vein recanalization three years post-thrombosis.
Conclusions:
- The May-Husni procedure is effective in a highly selected group of patients with severe post-thrombotic syndrome.
- Refining patient selection criteria requires further studies using hemodynamic assessments and validated post-thrombotic syndrome grading scales.
