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Autologous sapheno-saphenous bypass collateral development in the setting of chronic unilateral iliac vein occlusion
Julie Kelman1, Nicholas Xiao1, Jeremy D Collins1
11Department of Radiology, Section of Interventional Radiology, Northwestern University, 676 N. St. Clair, Suite 800, Chicago, IL 60611 USA.
Insights
A novel venous drainage pathway, sapheno-saphenous bypass collateral, is identified in chronic iliac vein occlusion. This finding aids in diagnosing venous obstructive pathology and guiding treatment.
Area of Science:
- Vascular Surgery
- Venous Imaging
- Interventional Radiology
Background:
- Chronic iliac vein occlusion leads to diverse collateral venous drainage.
- Autologous sapheno-saphenous bypass collateral drainage is a newly described pathway.
- This pathway is visible on cross-sectional imaging and indicates venous obstructive pathology.
Purpose of the Study:
- To describe the novel sapheno-saphenous bypass collateral drainage pathway.
- To highlight its diagnostic significance in chronic obstructive venous pathology.
- To discuss technical considerations for venous recanalization of these collaterals.
Main Methods:
- Case report detailing two patients with chronic unilateral iliac vein occlusion.
- Utilized computed tomographic venography for imaging.
- Documented findings and technical aspects of sapheno-saphenous collateral recanalization.
Main Results:
- Successful venous recanalization of sapheno-saphenous collaterals was achieved in both cases.
- One-month follow-up showed resolution of patient pain and improvement in edema.
- Computed tomographic venography confirmed stent patency.
Conclusions:
- Sapheno-saphenous collateral identification is crucial for diagnosing underlying venous obstructive pathology.
- This finding guides appropriate corrective interventions.
- The pathway serves as a diagnostic indicator for chronic venous obstructive disease.
Background:
Chronic iliac vein occlusion can result in the development of a variety of collateral venous drainage pathways. While several drainage pathways have been well documented, autologous sapheno-saphenous bypass collateral drainage has not been described. This novel collateral drainage pathway is readily visible on cross sectional imaging, may serve as a diagnostic indicator of chronic obstructive venous pathology, and may hint at the underlying etiology.
Case Presentation:
This brief report depicts findings and technical considerations in two cases of venous recanalization of sapheno-saphenous collaterals in the setting of chronic unilateral iliac vein occlusion. In both cases at one-month follow-up, the patients' pain had resolved, edema had improved, and computed tomographic venography demonstrated stent patency.
Conclusions:
Identification of a sapheno-saphenous collateral can provide an important clue to the underlying venous obstructive pathology, therefore guiding corrective intervention.
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