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Description
Shooting date : 2016-12-12
Last update : 2017-11-02
Language(s) : English

Clinical data

  • 68 y old man
  • Varicose Vein surgery 1972 (age 24)
  • Bilateral lower limb venous ulcers x 24 years
  • ...

Clinical data

  • 68 y old man
  • Varicose Vein surgery 1972 (age 24)
  • Bilateral lower limb venous ulcers x 24 years
  • DVT L leg 2006
  • DVT R leg 2007
  • Multiple attempted superficial interventions

1st Plan

  • R IJV access 10F 23cm Cordis Brite tip
  • Access both groins CFV/PFV/FV- 5F sheaths
  • 5000 u IV Heparin
  • Venography- AP and Lateral
  • Cross from above or below with Cook Tri-Force
  • Glide wires (Terumo) or Roadrunner (Cook)

2nd Plan

  • Once “across” use 260 Lunderquist wires through and through
  • CRITICAL TO DETERMINE INFLOW
  • Pre dilate to
    • 24mm IVC
    • 16mm CIV
    • 14mm EIV/CFV

3rd Plan

  • Stents:
    • IVC Optimed Sinus XL 24/80 x 2/3
    • CIV Veniti Vici or Bard Venovo
    • EIV Bard Venovo/Wallstent/Cook Zilver Vena
    • CFV ?
  • Post dilate to nominal diameter stent
  • IVUS to confirm adequate stent expansion
  • Cone Beam CTV

Post operation

  • Active ulcers so cannot use Class 3 stockings
  • Pneumatic compression boots
  • Maintain full anticoagulation
  • Colour Doppler US day to confirm stent patency
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  • ibrahim A. thanks for this nice symposium

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