[Survey of therapy of deep venous thrombosis among members of the German Society of Vascular Surgery].
BACKGROUND
In the literature of the past 15 years, deep venous thrombectomy has been rarely described. The only indications reported for thrombectomy seem to be recurrent pulmonary embolisation and phlegmasia coerulea dolens. Many contraindications and severe complications are making decisions concerning thrombolysis very difficult. At present, anticoagulation therapy is preferred over fibrinolysis. There is no conclusive concept for the standardization of treatment for deep venous thrombosis. As a first step towards achieving this, it was necessary to know what therapy is performed in hospitals throughout Germany.


METHODS
In 1999, we sent letters of enquiry to the members of the "Deutsche Gesellschaft für Gefässchirurgie". We wrote to 341 members (hospitals), and the information gained by means of a questionnaire was analysed and evaluated.


RESULTS
We received answers from 39.9% (n = 136) of the members. In all, 69% of the hospitals had an independent vascular department. In 1999, 6,718 patients underwent treatment for deep venous thrombosis, on average, 51 patients per hospital. Overall, 7,665 therapies were performed in one year (15.9% thrombectomy, 18.6% fibrinolysis, and 65.5% only anticoagulation). Only 23.5% of the hospitals had their own data about the outcome of their patients. The patency rate was 71.8% for thrombectomy and 48.9% for fibrinolysis. A severe postthrombotic syndrome was seen in 6.2% after thrombectomy, in 8.1% after fibrinolysis, and in 10.4% after singular anticoagulation.


CONCLUSIONS
At present, there is still no standardized concept for the treatment of patients with deep venous thrombosis. It seems that there are better results for some indications with thrombectomy than with other methods. For the establishment of a concept of treatment, a prospective randomised study is necessary.
Pillny
M
M
Klinik für Gefässchirurgie und Nierentransplantation, Universitätsklinikum, Heinrich-Heine-Universität, Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf. Pillny@med.uni-duesseldorf.de
Luther
B
B
Müller
B T
BT
Sandmann
W
W
D000925:Anticoagulants / Q000627:therapeutic use; D004363:Drug Utilization; D005858:Germany; D006306:Health Surveys; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D012955:Societies, Medical; D017131:Thrombectomy / Q000706:statistics & numerical data; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data; D014656:Vascular Surgical Procedures; D020246:Venous Thrombosis / Q000453:epidemiology / Q000628:therapy*
D000925:Anticoagulants