Surgical Treatment of Oblitating Lesion of the Lower Limb Vessels Associated With a Rare Anomaly of the Inferior Vena Cava System and Lower Limb Veins According to Dopplerography Ultrasound Data (clinical Cases)
Year: 2025
Type: article
Study design: Case Report
Abstract: Familiarity with the different variants of the inferior vena cava and lower extremity veins plays a crucial role in ultrasound examination. Vascular anomalies, although rare, should be considered when planning surgical treatment in patients with lower extremity vascular pathology. Anomalies of the inferior vena cava (IVC) are relatively rare. They should be identified before planned vascular surgery due to the risk of complications. The described cases serve as a valuable addition to the knowledge of the vascular system that physicians use in their daily practice when performing diagnostic ultrasound examinations. Aim. To demonstrate rare variants of the clinical course of surgical treatment of two patients with atherosclerotic lesions of the aortoiliac segment and congenital anomalies of the inferior vena cava. Material and methods. An analysis of clinical observations (cases) of surgical treatment for atherosclerosis of the aortoiliac segment and arteries of the lower extremities in patients with congenital anomalies of the venous system of the lower extremities, namely the inferior vena cava (IVC), was conducted. Both patients underwent right-sided aortodeep femoral bypass with a synthetic prosthesis and the main blood flow was restored. Congenital anomalies of the IVC must be remembered and taken into account not only intraoperatively, but also at the stage of instrumental diagnostics of vascular pathology when planning reconstructive operations in patients with chronic pathology of the vessels of the lower extremities. Research results and discussion. The two clinical cases presented serve as evidence of the possibility of successful reconstructive surgery for atherosclerotic lesions of the aortoiliac segment in patients with concomitant congenital anomalies of the IVC. Ultrasound has high sensitivity and specificity in detecting DVT (97 and 94 %, respectively) and allows you to visualize the IVC practically along its entire length. Additional instrumental non-invasive diagnostic methods in patients with atherosclerosis of the aortoiliac segment and peripheral arteries allow you to obtain the maximum possible amount of information about the localization and prevalence of pathological changes in the arterial bed, as well as for preoperative assessment of the condition of the IVC and the detection of congenital vascular anomalies. Variants of individual anatomical features of the structure and location of the IVC must be taken into account when planning reconstructive operations on the abdominal aorta and iliac arteries. Accurate preoperative knowledge of the anatomy of the IVC and its tributaries allows avoiding iatrogenic damage to these vessels during unilateral aorto-deep femoral bypass with a synthetic prosthesis. Conclusions. Careful collection of anamneses in patients of this group and performance of ultrasound Dopplerography of the vessels of the lower extremities allowed to establish the correct diagnosis in the preoperative period. Understanding by specialists of the possibilities of ultrasound of the vessels of the lower extremities, as well as compliance with the full protocol of the study during ultrasound Dopplerography allows to provide detailed information in order to determine the most effective treatment tactics and to prevent complications of the disease.
Authors: V. Boyko, H. Novikova, V. Bohdan, I. Babynkina
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4410009153