ArticleVascular specialist international2025
Modified Palma Bypass Using the Deep Femoral Vein as the Inflow for Severe Post-Thrombotic Syndrome: A Case Report.
Article in Vascular specialist international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Iliofemoral post-thrombotic syndrome may lead to severe venous claudication and leg ulceration. Surgical bypass remains a valuable alternative when endovascular recanalization is unsuccessful. We present a modified Palma procedure using the deep femoral vein (DFV) as an inflow, given the unavailability of the common femoral vein. A 40-year-old man with chronic left leg pain, edema, and ulceration had complete occlusion of the left iliofemoral axis with failed percutaneous attempts. A crossover bypass was performed using the contralateral great saphenous vein, anastomosed end-to-side to the DFV. Postoperatively, pain and edema resolved, and the ulcer healed within 90 days. Duplex ultrasonography at 2 months confirmed graft patency with preserved phasic flow. This technical modification offers a feasible alternative for complex post-thrombotic cases when conventional inflow sites are compromised and may expand surgical options for deep venous reconstruction.
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