title: Longterm results after surgical thrombectomy and simultaneous stenting for symptomatic iliofemoral venous thrombosis.
abstract: 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.
authors.affiliation: Department of Vascular and Endovascular Surgery, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. peter.hoelper@med.uni-heidelberg.de
authors.forename: P
authors.initials: P
authors.lastname: Hölper
authors.forename: D
authors.initials: D
authors.lastname: Kotelis
authors.forename: N
authors.initials: N
authors.lastname: Attigah
authors.forename: A
authors.initials: A
authors.lastname: Hyhlik-Dürr
authors.forename: D
authors.initials: D
authors.lastname: Böckler
mesh_terms: 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