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KMID : 0904020090250010023
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Journal of Korean Society for Vascular Surgery
2009 Volume.25 No. 1 p.23 ~ p.29
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Palma-Dale Operation for Chronic Ilio-femoral Vein Thrombosis
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Kim Sang-Dong
Park Sun-Cheol
Kim Ji-Il
Won Yong-Sung
Yun Sang-Seob
Moon In-Sung
Park Jang-Sang
Koh Yong-Bok
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Abstract
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Purpose: Deep vein thrombosis is usually managed conservatively or with radiologic intervention. Yet deep vein reconstruction is of value as one of the treatments for a small group of patients who present with significant chronic venous insufficiency due to hypoplastic, absent or occluded deep venous outflow such as occurs because of chronic ilio-femoral vein thrombosis. Therefore, we evaluate the improvement of symptoms and graft patency after a Palma-Dale operation as a treatment modality for chronic ilio-femoral vein thrombosis.
Methods: From January 2001 to August 2008, a retrospective study was performed on 15 patients with chronic ilio-femoral vein thrombosis that was treated with a Palma-Dale operation.
Results: The mean age of the patients was 51.1±15.9 years. The ratio of males to females was 8 to 7. All the patients had lower limb swelling. A Palma-Dale operation was performed on all the patients. Simultaneous thrombectomy was done for 1 patient and arteriovenous fistulas were used to improve graft patency in four patients. The mean follow-up period was 36.3±24.0 months. Postoperatively, there was improvement of symptoms in all the patients. However, there was recurrence of symptoms in three patients after two or three months. The rate of graft patency was 84.1% at one year after surgery.
Conclusion: The Palma-Dale operation has the possibility of recurrence of deep vein thrombosis and postoperative complications. Yet in patients with significant chronic venous insufficiency due to chronic ilio-femoral vein thrombosis, this type of surgery is obviously of value with respect to improvement of symptoms and an acceptable graft patency rate.
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KEYWORD
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Chronic ilio-femoral vein thrombosis, Palma-Dale operation
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