Late results of iliofemoral venous thrombectomy

Abstract

Venous thrombectomy should be considered for primary treatment in selected cases of early iliofemoral venous thrombosis.

All-Cause and Potentially Disease-Related Health Care Costs Associated with Venous Thromboembolism in Commercial, Medicare, and Medicaid Beneficiaries

“…26 A study by Yamaki and Nozaki (2005) investigated patterns of venous insufficiency after DVT and found that the limbs involving multisegment DVTs on initial examination had a higher incidence of deep vein insufficiency compared with single segment DVT. 30 A study by Juhan et al (1997) also reported that among patients with surgical venous thrombectomy, the surgical removal of a large blood clot, the rate of valvular insufficiency was 20% at 5 years and 44% at 10 years. 31 These potentially disease-related, exploratory endpoints were studied separately from PTS as independent outcomes.…”

“…30 A study by Juhan et al (1997) also reported that among patients with surgical venous thrombectomy, the surgical removal of a large blood clot, the rate of valvular insufficiency was 20% at 5 years and 44% at 10 years. 31 These potentially disease-related, exploratory endpoints were studied separately from PTS as independent outcomes. However, some ICD-9-CM codes used to define the exploratory endpoints overlap with the definition of PTS (Appendix).…”

“…Additional exploratory endpoints were identified a priori based on the literature reviewed by the authors during the study protocol development prior to conducting the study analyses. [21][22][23][24][25][26][27][28][29][30][31] These exploratory endpoints included thrombocytopenia, superficial venous thrombosis, venous ulcer, pulmonary hypertension, stasis dermatitis, and venous insufficiency (Appendix).…”

Histological Study on the Left Common Iliac Vein Spur

“…In previous studies on common iliac vein spurs in autop sied patients, spurs near the confluence of the left common iliac vein were observed in 10 of 32 patients (32%) by McMurrich, 10) 98 (24%) of 412 by Ehrich,11) 19% of 430 patients by May and Thurner, et al, 12) and 14 (14%) of 100 patients by Negus, et al 13) Vollmar, et al 14) observed spurs after throm bectomy of left iliac vein thrombosis using a vascular endoscope in 50%, and Juhan, et al 15) observed spurs on venography in 62%. Although the frequency of spurs varies among reports, they are not necessarily rare.…”

Invasive Approaches to Treatment of Venous Thromboembolism

“…41 Creation of an arteriovenous fistula can also augment blood flow across the thrombectomized, thrombogenic luminal venous surface, 42 and percutaneous strategies have been developed to close the fistula once venous re-endothelialization is complete. 42 Juhan et al reported an 84% long-term venous patency rate with surgical venous thrombectomy in 77 patients followed up for a mean of 8.5 years 43 ; the same group had previously reported an immediate rethrombosis rate of Ͻ10%. 44 The rate of valvular insufficiency was 20% at 5 years and 44% at 10 years; 90% of patients had nonexistent or mild symptoms of venous insufficiency.…”