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


CONCLUSIONS
Venous thrombectomy with simultaneous stenting results in excellent longterm results in selected patients with symptomatic iliofemoral venous thrombosis.
Hölper
P
P
Department of Vascular and Endovascular Surgery, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. peter.hoelper@med.uni-heidelberg.de
Kotelis
D
D
Attigah
N
N
Hyhlik-Dürr
A
A
Böckler
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation*; D003131:Combined Modality Therapy; D003251:Constriction, Pathologic; D005240:Feasibility Studies; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D017131:Thrombectomy / Q000009:adverse effects; D015912:Thrombolytic Therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D055815:Young Adult