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Thorac Cardiovasc Surg 1984; 32(5): 299-303
DOI: 10.1055/s-2007-1023408
© Georg Thieme Verlag Stuttgart · New York

Early Phlebographic Results after Iliofemoral Venous Thrombectomy

P. Stirnemann1 , U. Althaus1 , B. Kirchhof1 , J. Triller2 , B. Nachbur1 , A. Senn1
  • 1Department of Thoracic and Cardiovascular Surgery,
  • 2Department of Radiology, University of Berne, Switzerland
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Publication History

1984

Publication Date:
30 April 2008 (online)

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Summary

The results of conventional venous thrombectomy performed in 37 patients with acute iliofemoral thrombosis were evaluated with special reference to early postoperative phlebography. In all patients thrombosis was verified preoperatively by angiography. No mortality was encountered, but the leg of one patient with Phlegmasia coerulea dolens and advanced venous gangrene had to be amputated at the above-knee level. Four patients had pulmonary embolism in relation to surgery. Based upon postoperative phlebography, complete clearance of all obstructed segments was achieved in 5 patients only (13.5%), and subtotal or partial restoration resulted in 9 patients (24%). In 16 cases (43%) postoperative phlebograms appeared equivalent to the preoperative study, and in 7 cases (20%) additional vein Segments were occluded. Despite the relatively high incidence of recurrent thrombosis, prompt relief of Symptoms occurred in the great majority of patients.

The more favorable angiographic results were obtained in the ilio-femoral segment; in contrast, new occlusions were predominantly found in the popliteal-crural segments. Restoration of a venous passage was not correlated with the duration of symptoms, in most instances, the removed clots appeared organized and adherent tu the vein intima, even in patients with a short clinical history. With regard to probable etiological factors, somewhat better results were achieved for patients exposed to previous surgery or trauma and for patients with severe medical illness. In our view indications for venous thrombectomy should be rather restrictive;.successful clearance and long-term patency can be expected mainly in patients with clots lying in the ilio-femoral segment surrounded by contrast medium in the distal portion.

The results of surgical thrombectomy depend heavily upon the expertise of the performing surgeon and can possibly be improved by newer technical modifications.

Key words

Iliofemoral venous thrombectomy - Early phlebographic results

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