Prosthetic replacement of the inferior vena cava and the iliofemoral vein for urologically related XXXX .

@entity1 @entity706 @entity575 @entity5 @entity450 @entity1492 @entity177 @entity1358 @entity150 @entity432 @entity3 @entity27418 @entity204 @entity703
OBJECTIVE: To evaluate the feasibility and results of prosthetic venous replacement, as inferior vena cava (IVC) and iliofemoral vein resection and replacement are sometimes necessary when they are extensively involved by a large and fixed @entity5 thrombus from @entity1358 ( @entity1358 ) or other @entity5 . @entity1 AND METHODS: Five @entity1 and two @entity1 (age range 41-75 years) were treated over a 10-year period (1991-2001) by aggressive venous surgery to achieve complete @entity5 resection, with prosthetic graft replacement to re-establish venous flow. The @entity5 included @entity703 (two), @entity27418 (two), @entity150 (one), @entity1492 (one) and inguino-pelvic @entity706 (one). Two @entity1 had a vena caval replacement, of whom one had a circular reinforced PTFE and one a Dacron @entity575 graft; five @entity1 had either an iliofemoral or an ilio-iliac circular reinforced PTFE graft. The prosthetic diameter was 18-20 mm for the IVC grafts and 8-10 mm for the iliac grafts. In all the @entity1 , graft patency was evaluated during the follow-up by colour flow duplex imaging, and in one it was determined by angio-computed tomography scan and venography. RESULTS: One @entity1 died 30 days after surgery; of the remaining six @entity1 one had no evidence of regional recurrence or @entity3 at 12 months, and five died from recurrent @entity5 8-30 months after surgery. The mean time to @entity204 was 23 months. At 3 months all six prosthesis were patent; at 6 months four were patent and at 12 months three of five prostheses were patent. CONCLUSION: Resecting and replacing the @entity5 resection and avoids @entity177 , providing durable relief from the symptoms of @entity432 . Iliofemoral prosthetic reconstruction for urological-related @entity5 represents a viable option to avoid @entity450 and lower extremity swelling, at least in the early postoperative period. The mean time to @entity204 for the present @entity1 must be considered the limit for these aggressive operations.
