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International Surgery and Ortho Conference
October 25-26, 2017 | Toronto, Canada
Case Rep Surg Invasive Proced 2017 | Volume 1 Issue 3
Venoplasty: A less frequent but essential procedure
Abdullah Al Jamil
Asgar Ali Hospital, Bangladesh
Statement of the Problem:
Balloon venoplasty and stenting of
venous obstruction was introduced in late 1980s and 1990s.
Earliest venous stenting was done in 1997. It is less frequent but
recognized essential procedure. Its clinically significant is more
common in upper than lower extremities. Most commonly
affected sites include axillary, brachial, cephalic, Subclavian,
Superior vena cava, Femoral and Iliac veins. Majority of cases
are hemodialysis catheter related from intimal hyperplasia and
fibrosis due to intimal trauma secondary to catheter movement
during cardiac cycle or due to propagating infection along the
venous wall from entry point. Other causes include central
venous catheter, pacemaker leads, radiation, trauma or external
compression. Venous stenosis presentswith swelling of affected
area of drainage. Duplex scanning is less reliable in subclavian
veinwhereas venography is less reliable in femoral and iliac vein
obstruction. Endovascular therapy is the effective modality of
treatment. Balloon angioplasty preferred in subclavian veins
and stenting preferred in femoral or iliac veins.
Outcome:
In subclavian balloon angioplasty luminal diameter
improvement in 70%, elastic recoil in 23% and failed in 7%.
Restenosis develops in 81% at 7.6 months; one-year patency
35% and two-year patency 6%. Primary patency in subclavian
stenosis varies from 20% to 70%. Repeat procedure is needed
in large number of patients. Femoral or iliac vein stenting has no
in-stent restenosis at 27±4 months but stent thrombosis in 4%.
Conclusion & Significance:
Majority of venous obstructions
are iatrogenic mostly hemodialysis patients. It’s a less frequent
procedure but essential to keep open the vein related to
dialysis, the lifeline for the patient. Need for repeat procedure
is very high.
Speaker Biography
Abdullah Al Jamil graduated from Sher-E-Bangla Medical College, under Dhaka
University, Bangladesh in 1988. He has started his career as House Physician in
Department of Medicine, IPGMR, Dhaka. Then, he has served in CCU and Internal
Medicine, Dhaka Medical College Hospital as Assistant Registrar and Registrar. He has
obtained Fellowship in Medicine from Bangladesh College of Physicians and Surgeons
in 1997. Subsequently, he has worked as Junior Consultant, Medicine, Shaheed
Suhrawardy Hospital, Dhaka for three years. He has obtained MD Cardiology from
Dhaka University in 2001. He has worked as Assistant and Associate Professor of
Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka over three years.
Then, he has joined at Square Hospital as Consultant, Interventional Cardiology in
January 2007. He has joined the present working place in June 2016. He has attended
several International Conferences as faculty, and presented papers in USA, Switzerland,
Japan and Singapore. He has performed 2130 procedures including PCIs, Device
Implantations, Balloon Valvuloplasties, Peripheral Angioplasties and EPS and RFA.
e:
aalj61@yahoo.com