title: Original approach for thrombolytic therapy in patients with Ilio-femoral deep vein thrombosis : 2 years follow-up.
abstract: OBJECTIVE
  The aim of the study was to discuss the results of catheter-directed thrombolysis and complementary procedures to treat acute iliofemoral deep vein thrombosis (DVT) evaluating the safety and effectivness of an easy access such as the Great Saphenous Vein.
  
  
  METHODS
  A total of 22 consecutive patients with iliofemoral thrombosis and two patients with femoro-popliteal thrombosis on recent onset diagnosed with Ultrasound Doppler and contrast venography underwent intrathrombus drip infusion of urokinase while intravenous heparin was continued using saphenical access. Residual venous stenosis were treated in six patients by percutaneous balloon Angioplasty and stenting. All patients underwent routine venous duplex imaging at 30 days, 3 months, 6 months and every 6 months thereafter.
  
  
  RESULTS
  Complete patency of thrombosed veins was restored in 22 patients (91 %) with prompt symptomatic relief. There were no major complications in the immediate outcomes. At follow-up, two patients reported a persistant slim iliac vein stenosis, two patients had post-thrombotic syndrome, and two patients showed Deep Vein Reflux.
  
  
  CONCLUSIONS
  Local thrombolysis using saphenical access was a safe and effective approach for the treatment of acute iliofemoral deep vein thrombosis. It seems to be a valid, easy and safe alternative, reducing the risks of haematoma and venous lesions, which can be observed when using femoral, popliteal, and trans-jugular access.
authors.affiliation: Vascular Surgery Department, King's College Hospital, London, United Kingdom.
authors.forename: Leslie
authors.initials: L
authors.lastname: Fiengo
authors.affiliation: Department of Vascular Surgery, Polyclinique Bordeaux Rive Droite, Lormont, France.
authors.forename: Federico
authors.initials: F
authors.lastname: Bucci
authors.affiliation: Vascular Surgery Department, King's College Hospital, London, United Kingdom.
authors.forename: Elias
authors.initials: E
authors.lastname: Khalil
authors.affiliation: Vascular Surgery Department, La Sapienza University, Rome, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Salvati
keywords: Caval filter; Deep vein thrombosis; Endovenous technique; Saphenous vein; Thrombolysis