# Successful Surgical Treatment of a Spontaneous Rupture of the Left Iliac Vein: What Is the Optimal and Radical Treatment?

## TL;DR

This paper presents a successful two-stage surgical approach for treating a rare case of spontaneous rupture of the left iliac vein.

## Contribution

The paper introduces a combined surgical strategy involving vein replacement and arteriovenous bypass for radical treatment of SRIV.

## Key findings

- Initial surgery with thrombus removal and direct venous repair failed due to early occlusion.
- A second surgery using a Gore-Tex graft and arteriovenous shunt led to successful recovery without recurrence.
- A single-stage procedure combining hemostasis, vein replacement, and bypass may be optimal for SRIV.

## Abstract

Spontaneous rupture of the iliac vein (SRIV) requires surgical hemostasis and venous return restoration. We herein report a case treated with initial thrombus removal and direct venous repair. Because of early occlusion, a 2nd surgery was performed for iliac vein reconstruction using a 14-mm ringed Gore-Tex graft (W. L. Gore & Associates, Newark, DE, USA), and a 4-mm Gore-Tex arteriovenous shunt was created between the femoral artery and the femoral vein to prevent reocclusion. The patient had an uneventful recovery without recurrence. A single-stage procedure including hemostasis, vein replacement, and arteriovenous bypass may be ideal for radical SRIV treatment.