Longterm results after surgical thrombectomy and simultaneous stenting for symptomatic iliofemoral venous thrombosis

Eur J Vasc Endovasc Surg. 2010 Mar;39(3):349-55. doi: 10.1016/j.ejvs.2009.09.028. Epub 2010 Jan 8.

Abstract

Objectives: To evaluate the longterm outcome of venous thrombectomy and simultaneous stenting in patients with acute, symptomatic iliofemoral deep venous thrombosis (DVT).

Methods: Between January 1996 and December 2007, a total of 45 patients underwent venous thrombectomy at our institution. Thrombectomy results were classified by intraoperative phlebography as: TYPE I=complete, TYPE II=partial, TYPE III=complete with stenosis other than thrombus, TYPE IV=permanent occlusion. TYPEs I and IV were excluded from this analysis because no endovascular repair was performed. 25 patients underwent a venous hybrid operation comprising balloon-catheter thrombectomy, thrombolysis and stenting of residual stensosis. Three TYPE 2 and 22 TYPE 3 lesions were diagnosed. Three patients died during follow-up from causes unrelated to their treatment. Three were lost to follow-up. Hence, 19 patients were examined. A retrospective, non comparative single-centre study was performed.

Results: Median follow-up was 68 months (range 3-129). Primary and secondary patency rates were 74% (14/19) and 84% (16/19), respectively. Re-thrombosis occurred within seven days of operation in 26% (5/19). Procedure related mortality was zero. There was no case of late re-thrombosis. Four patients showed post-thrombotic sequelae (CEAP: C1, 2 or 3s). No leg ulcer developed in any patient.

Conclusion: Venous thrombectomy with simultaneous stenting results in excellent longterm results in selected patients with symptomatic iliofemoral venous thrombosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angiography, Digital Subtraction
  • Angioplasty / adverse effects
  • Angioplasty / instrumentation*
  • Combined Modality Therapy
  • Constriction, Pathologic
  • Feasibility Studies
  • Female
  • Femoral Vein / diagnostic imaging
  • Femoral Vein / physiopathology
  • Femoral Vein / surgery*
  • Humans
  • Iliac Vein / diagnostic imaging
  • Iliac Vein / physiopathology
  • Iliac Vein / surgery*
  • Male
  • Middle Aged
  • Phlebography / methods
  • Recurrence
  • Retrospective Studies
  • Stents*
  • Thrombectomy* / adverse effects
  • Thrombolytic Therapy
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Vascular Patency
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / physiopathology
  • Venous Thrombosis / surgery
  • Venous Thrombosis / therapy*
  • Young Adult