Late results of iliofemoral venous thrombectomy.
OBJECTIVE
Although anticoagulation therapy for iliofemoral venous thrombosis prevents pulmonary embolism, it is not designed to avoid the postthrombotic syndrome. Mechanical removal of the thrombus in the form of venous thrombectomy should yield better long-term results. The purpose of our study was to analyze the clinical outcome and venous valvular function of limbs 5 to 13 years after iliofemoral venous thrombectomy.


METHODS
Seventy-seven lower extremities underwent venous thrombectomy for acute iliofemoral venous thrombosis and were monitored for a mean follow-up of 8 1/2 years (range, 5 to 13 years). Patency of the iliofemoral venous system, competence of the femoral popliteal valves, and clinical signs and symptoms of chronic venous insufficiency were evaluated in each case.


RESULTS
Subsequent to early perioperative failure, patency remained stable over time at 84%. Valvular competence was preserved in 80% at 5 years; however, it decreased to 56% at 10 years. It is important that more than 90% of the limbs had no symptoms or mild symptoms of chronic venous insufficiency.


CONCLUSIONS
Venous thrombectomy should be considered for primary treatment in selected cases of early iliofemoral venous thrombosis.
Juhan
C M
CM
Vascular Surgery Department, Hôpital Nord, Chemin des Bourrely, Marseille, France.
Alimi
Y S
YS
Barthelemy
P J
PJ
Fabre
D F
DF
Riviere
C S
CS
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005268:Femoral Vein; D005500:Follow-Up Studies; D006801:Humans; D007084:Iliac Vein; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D017131:Thrombectomy / Q000009:adverse effects; D013927:Thrombosis / Q000601:surgery; D017211:Treatment Failure; D014654:Vascular Patency; D014689:Venous Insufficiency / Q000209:etiology