SURGICAL TREATMENT OF EXTRAVASAL COMPRESSION OF MAJOR VEINS IN CHILDREN

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Abstract

Rationale: angiodysplasia may account for about 5% of all cases of  vascular abnormalities. Patients with angiodysplasia of pelvis and  lower limbs constitute half of the total amount of persons suffering  from that disease. Patients with venous dysplasia relate to the most  numerous group of those with angiodysplasia.

Purpose of the study: determine basic syndromes found in  extravasal compression of the venous bed in children, determine the  pathogenetic value of the syndromes during formation of the venous  pathology in children and adolescents and develop the treatment method of the pathology.

Materials and methods: The following surgeries were performed:  transposition of the right common iliac artery and balloon  angioplasty in May-Thurner syndrome, formation of gonadoiliac anastomoses in phleborenohypertension, and removal of  the cervical rib in venous type of the thoracic outlet syndrome (TOS).

Results and their discussion: The main causes of small pelvis  varices were as follows: valvular insufficiency (ovaricovaricocele and  varicocele) in 2 of 3 of cases, aortomesenterial compression, in May- Thurner syndrome in 1 of 3 cases. The thoracic outlet syndrome (TOS) was found in eleven patients.

Conclusions: staged balloon angioplasty combined with removal or  hardening of veins can be the method of choice in patients with  moderate May-Thurner syndrome. Transposition of the right CIA can  be the method of choice in patients with severe May-Thurner  syndrome. Gonadoiliac shunting is chosen in patients with small  pelvis varices associated with mesoaortic compression. Removal or  resection of the cervical rib is done in patients with the thoracic  outlet syndrome due to the additional cervical rib.

About the authors

R. V. Garbusov

Russian Children’s Clinical Hospital

Pirogov Russian National Research Medical University of the Ministry of Health of Russia

Author for correspondence.
Email: 9369025@mail.ru

Доктор медицинских наук, врач РХМДиЛ ФГБУ РДКБ Минздрава России. Научный сотрудник НИИ хирургии детского возраста ФГБОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Russian Federation

Yu. A. Polyaev

Russian Children’s Clinical Hospital

Pirogov Russian National Research Medical University of the Ministry of Health of Russia

Email: fake@neicon.ru

Доктор медицинских наук, профессор, заведующий отделением РХМДиЛ ФГБУ РДКБ Минздрава России. Заведующий отделом НИИ хирургии детского возраста ФГБОУ ВО РНИМУ им. Н. И. Пирогова МЗ РФ

Russian Federation

A. A. Mylnikov

Russian Children’s Clinical Hospital

Email: fake@neicon.ru
Кандидат медицинских наук, врач РХМДиЛ ФГБУ РДКБ Минздрава России Russian Federation

M. N. Sukhov

Russian Children’s Clinical Hospital

Email: fake@neicon.ru

Доктор медицинских наук, заведующий отделением сосудистой хирургии ФГБУ РДКБ МЗ РФ

Russian Federation

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Copyright (c) 2017 Garbusov R.V., Polyaev Y.A., Mylnikov A.A., Sukhov M.N.

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