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reconstruction is a surgical procedure to reconstruct a weakened or
damaged vein. The procedure is most often used to treat venous
insufficiency, a chronic condition in which a vein has problems sending
blood from the legs to the heart. The problem arises as a result of a
weakened vein wall or leaking valves. Over time venous insufficiency may
lead to a potentially life-threatening condition called deep vein
DVT is a blood clot (thrombus) that forms in
a large, deep vein, usually in your lower leg, thigh, or pelvis. This
blood clot can break off and travel through the blood stream. If the
loose clot (embolism) travels to your lungs, brain or heart, it can
cause serious damage or death. For this reason, if you suffer from
chronic, serious venous insufficiency or chronic DVT, your doctor may
recommend venous reconstruction to address the underlying cause.
In addition to DVT, venous insufficiency
can lead to ulcers within the veins. Most ulcers heal quickly after
superficial vein surgery, but if the ulcers are deep within the vein,
treatment to correct the insufficiency may be recommended. To
reconstruct a faulty valve causing venous insufficiency, your
radiologist uses advanced X-ray imaging technology to maneuver a tiny
(catheter) tube outfitted with surgical tools through a small incision
in the vein near the damaged or weakened valve.
Several techniques exist to reconstruct
ineffective valves, including suturing a fold into the external wall of
the vein or wrapping it in a sleeve or band. Both procedures are
performed to decrease the diameter of the vein to improve venous flow.
Venous reconstruction may require an overnight stay in the hospital,
although some patients return home the same day.
Before venous reconstruction became
available, venous insufficiency treatment focused primarily on lifestyle
changes, such as wearing compression stockings, not sitting for long
periods, quitting smoking, and losing weight.
Risk factors for venous insufficiency may include:
Symptoms of venous insufficiency may include:
Diagnosis of Venous Insufficiency:
To diagnose venous insufficiency, your
doctor will ask about your symptoms and take a detailed medical history.
He or she will also perform a physical exam to look at your leg veins
when you are standing and sitting with your legs dangling. A duplex
ultrasound exam of your leg may also be recommended to check blood flow
in the veins and rule out other problems, such as a blood clot.
Deep Vein Thrombosis Clots
Before venous reconstruction became
available, anticoagulants (blood thinners) were often the standard of
care for people with deep vein thrombosis (DVT). Blood thinners
gradually dissolve the clot but don’t get rid of it completely. In the
case of chronic, serious blood clots, your doctor may recommend venous
reconstruction to completely remove the clot and repair the vein at the
surgical site. The rationale for removing the clot is two-fold: to
eliminate the obstruction and to preserve valve function.
To remove the clot and repair the valve,
your radiologist uses advanced X-ray imaging technology to maneuver a
tiny tube (catheter) through a small incision in the vein near the clot.
The radiologist opens the vessel to physically remove the clot rather
than dissolve it. After removing the clot, your doctor may reconstruct
the valve. This often involves attaching a small piece of artery to
reroute blood flow to an area that has been prepared with stents,
temporary tubes placed in the blood vessel to lend support. An
interventional radiology procedure called balloon angioplasty may also
be used to open blood vessels by inserting tiny surgical balloons.
Preventive measures for DVT include:
Risk factors for DVT may include:
Symptoms of DVT may include:
DVT primarily affects the large veins in the lower leg and thigh, almost always on one side of your body and may include:
Diagnosis of DVT:
To diagnose DVT, your doctor will conduct a
physical exam, ask about your symptoms, and take a detailed medical
history. He or she may also order a D-dimer blood test to detect small
protein fragments that are present after a blood clot degrades and a
Doppler ultrasound exam to measure the blood flow in the major arteries
and veins of your legs.
If ongoing treatment has not been successful
in treating serious, chronic venous insufficiency or DVT, your doctor
may recommend venous reconstruction to address the underlying problem.
Your doctor will talk to you about all of your treatment options and
explain the venous reconstruction procedure in depth to make sure it is
right for you.
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