inferior vena cava occlusion

The use of inferior vena cava blockade can prevent fatal massive embolization or repeated non-fatal embolism. Inferior vena cava ligation this procedure has many disadvantages, such as the risk of surgery, venous return after vena cava blockage, affecting cardiac output and prone to postoperative complications such as lower extremity swelling, congestion and skin ulcers. Therefore, this method has rarely been adopted so far. Inferior vena cava net placement or placement of a special umbrella filter is currently widely used. The advantage of arranging the venous filter is that it can prevent the death of the larger embolus and cause the venous return, and the complications are less. Treatment of diseases: portal vein thrombosis portal hypertension Indication 1 There are contraindications to anticoagulation: such as large venous thrombosis that occurs rapidly after major surgery and severe trauma, heparin allergy or bleeding quality. 2 Re-emergence in anticoagulant therapy. 3 Deep vein thrombosis and embolism occurred repeatedly due to abnormal congenital coagulation mechanism. 4 repeated embolization. 5 major surgical operations are required, but patients have acute spasticity and femoral vein thrombosis. Contraindications Patients with systemic or cardiovascular disease cannot undergo surgery. Preoperative preparation 1. Patients with poor liver function should strengthen liver protection measures before surgery, including high protein, high calorie, high vitamin and low salt diet. 2. When the plasma protein is low, blood transfusion, plasma and albumin may be administered in small amounts. 3. Intestinal preparation 3 days before surgery, oral administration of neomycin, metronidazole, reducing the number of intestinal bacteria. 4. Preoperative B-ultrasound and other renal function tests to understand the functional status of the kidneys. Surgical procedure 1. Transabdominal transverse incision: After the laparotomy, the portal vein was examined, and when it was confirmed to be fibrotic, the transverse mesenteric membrane was straightened, and the peritoneum was cut in the right side of the duodenal jejunum. On the lower edge of the horizontal portion of the duodenum, the superior mesenteric vein was searched for the right side of the superior mesenteric artery. The lymphatic vessels that have dilated in the peritoneum should be properly ligated and sutured to prevent or reduce postoperative chyle ascites. 2. The superior mesenteric vein was freed for one week and was freed 4 cm in the horizontal part of the duodenum. The inferior vena cava was isolated on the right side of the spine and the inferior vena cava wall was also fully dissociated. 3. The duodenal descending and horizontal junctions are pulled to the left side, and the inferior vena cava can be found behind. Discharge down to the left and right iliac crest bifurcation. If the length is measured upward at the bifurcation, the inferior vena cava can be pulled to the superior mesenteric vein without tension. The lower vena cava can be cut from the bifurcation; If the length of the vein is not enough, the left common iliac vein can be cut, the broken end is sutured, and then cut from the right common iliac vein to prolong the length of the inferior vena cava. 4. Inferior vena cava - superior mesenteric vein lateral resistance: The inferior vena cava was pulled to the superior mesenteric vein, and the superior mesenteric vein was clamped with a non-invasive vascular clamp, which was blocked by surgical line ligation. complication There is a manifestation of venous stasis in the lower extremities, as well as the risk of detachment, migration, and venous perforation.

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