Abstract
The rapid progress of vascular surgery during the past few decades was exceeded the expectations of the most surgeons and investigators.
New diagnostic techniques such as the Doppler ultrasonic flowmeter, improved vascular substitutes of various types, and new surgical techniques have expanded the field of vascular surgery.
Endarterectomy, bypass techniques for treating arterial occulusive disease, and surgical resection and replacement of aortic aneurysms have been perfected. Recently, more noninvasive techniques such as percutaneous transluminal angioplasty, have been developed. The availability of the Fogarty embolectomy catheter now makes it possible, under local anesthesia, to extract emboli from all the most common sites, except the renal and other visceral arteries. Dotter first reported percutaneous transluminal angioplasty as a technique for treating atherosclerotic vascular stenoses and occlusions in 1964. Grüntzig described nonsurgical recanalization of superficial femoral artery occlusions and stenoses in the superficial femoral and pelvic arteries with the use of the Grüntzig balloon catheter. Bypass techniques and other forms of organ protection during thoracic aortic and carotid artery cross-clamping provide protection from temporary or permanent dysfunction.
A variety of disease entities can lead to arterial and venous stenoses, occlusions or dilatation, but here we are concerned exclusively with the problem of arteriosclerosis, Buerger's disease, venous thrombosis and inferior vena cava obstruction with Budd-Chiari syndrome. We treated 7 patients with inferior vena cava obstruction with the Budd-Chiari syndrome. Two patients were treated by a direct surgical approach to the inferior vena cava block, transcardiac membranotomy, and patching with autogenous pericardium after an open resection. Five were treated with a dilator, Fogarty and Grüntzig balloon catheter to fracture the membrane.
