The long-term outcome of proximal vein thrombosis during pregnancy is not improved by the addition of surgical thrombectomy to anticoagulant treatment.
OBJECTIVE
To compare the long-term outcome for pregnant/puerperal women with iliofemoral venous thrombosis treated either with thrombectomy and additional anticoagulants or with anticoagulants alone.


METHODS
Retrospective study of two treatment methods.


METHODS
Thirty women with iliofemoral venous thrombosis during pregnancy or puerperium were treated with thrombectomy and additional anticoagulants. Twenty-five women, with the same condition, treated with anticoagulants only were obtained from a registry. The mean follow-up time for both groups was 9 years. The patients of the two groups were well matched, had the same risk factor score and were comparable except for duration of symptoms before treatment.


METHODS
The follow-up comprised history and clinical examination, colour Duplex ultrasound and venous strain-gauge plethysmography.


RESULTS
Patency of iliac veins, symptoms of chronic venous disease, venous emptying and venous reflux did not differ between the groups. A significant reduction of outflow was found in 20% of the surgically treated patients and 16% of the controls. Impaired muscle pump function was seen in less than half of the patients in both groups.


CONCLUSIONS
Surgical thrombectomy does not offer any advantage over anticoagulation treatment alone in the long-term outcome for patients with iliofemoral venous thrombosis during pregnancy or puerperium.
Törngren
S
S
Department of Surgery, Stockholm Söder Hospital, Sweden.
Hjertberg
R
R
Rosfors
S
S
Bremme
K
K
Eriksson
M
M
Swedenborg
J
J
D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D010991:Plethysmography; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D011644:Puerperal Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D012042:Registries; D012189:Retrospective Studies; D017131:Thrombectomy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014654:Vascular Patency
D000925:Anticoagulants