Femoral-femoral Vein Crossover Bypass in a Case with Left Lower Leg Edema and Pain Caused Chronic Iliac Vein Occlusion

Abstract

We report here on a case of left common iliac vein occlusion in which a femorofemoral crossover bypass was effective. A 79-year-old woman had swelling in her lower left limb for a year, redness for the most recent six months of that year, and finally began to feel pain in her lower left limb. A physical exam showed pigmentation in the left lower leg. The circumference of the lower left leg was 5 cm larger than the right leg and 8 cm larger at the thigh. D-dimer values were normal. Ultrasonography showed no reflux in the lower limb veins. The obstruction was determined to be left iliac vein thrombosis. A contrast-enhanced CT showed an arteriovenous fistula and left iliac vein occlusion from the left internal iliac artery. A stent graft was implanted for the arteriovenous fistula, and the pain in the lower leg was alleviated. However, the left lower limb pain recurred 5 months later, so a femorofemoral crossover bypass operation was performed. After the bypass, the pain in the left lower limb was relieved, and eight months after the operation, no difference was observed between the right and left lower limbs.