An athletic 37-year-old man had a 17-year history of left leg varicosities secondary to iliofemoral vein occlusion of unknown etiology. He had undergone three regional superficial vein strippings, and had increasing pain from the groin varicosities and venous claudication from compartment syndrome on running more than one mile. The left iliofemoral venogram shows extensive pelvic, abdominal wall and gluteal collaterals. There was no increase in size of the left lower extremity over the right.
The patient elected to have left to right venous bypass. He was given an initial dose of 1mg/kg low molecular weight dextran (dextran 40), followed by a continuous infusion of 20 cc/h. The left femoral incision is shown, with bulging subcutaneous varicosities.
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