A 49-year-old patient presented with a slowly progressing about 7cm tumor in the left fossa poplitea. Ultrasonography and MRI showed a postthrombotic syndrome of the left leg with a chronic occlusion of the iliofemoral venes, pronounced inguinal collaterals as well as varix convolutions in the left fossa poplitea, which corresponded to the tumor complained. Endophlebectomy of the vena femoralis and vena femoralis profunda was carried out with a ventral reconstruction using bovine pericardial patch plasty followed by recanalization of the chronically occluded venous iliofemoral axis with stentangioplasty. Finally, an inguinal AV fistula was created. Postoperatively, the patient developed early reocclusion of the recanalized iliofemoral venous axis and an inguinal lymph fistula. Therefore, initially planned surgical recanalization was not possible. We performed a not successful percutaneous transjugular recanalization attempt. The inguinal healing took eight weeks to stop lymph exudation. After this time, we decided against an operative revision due to the expected poor secondary patency rate. The cause of the early reocclusion remains unclear, possible causes and resulting consequences are discussed.
Research Areas and Centers
- Research Area: Luebeck Integrated Oncology Network (LION)