Long-term Results after Transfemoral Venous Thrombectomy for Iliofemoral Deep Venous Thrombosis

Lindow, Christopher; Mumme, A.; Asciutto, Giuseppe; Strohmann, Barbara; Hummel, Thomas; Geier, B.

doi:10.1016/j.ejvs.2010.02.023

Cited by 35 publications

(18 citation statements)

References 14 publications

(14 reference statements)

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“…Only Plate et al reported 10 year results prospectively and a patency rate of 83% after surgical thrombectomy [12]. These data have been confirmed by others and by our previously published results [1,13,16]. For example, Hölper et al reported primary and secondary patency rates after a mean follow-up of 64 month of 74% and 84% respectively [1] and Wagenhäuser et al described primary patency rates of 89% after a mean follow-up of 63 month [13].…”

Section: Discussionmentioning

confidence: 54%

“…Thus, a subgroup analysis of this study shows a benefit in the reduction of severe PTS for the use of pharmacomechanical catheter-directed thrombolysis, limited to patients with an iliofemoral DVT [11]. However, there have been demonstrated good results for surgical thrombectomy of iliofemoral DVT in terms of prevention of PTS as well [1,8,[12][13][14][15][16][17]. Even though duplex ultrasound mapping is the gold standard in the diagnosis of venous diseases including PTS [18], other noninvasive diagnostic methods e.g.…”

Section: Introductionmentioning

confidence: 97%

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Surgical thrombectomy for iliofemoral deep vein thrombosis: Patient outcomes at 8.5 years

et al. 2020

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Introduction Deep vein thrombosis (DVT) is a frequent burden and a post-thrombotic syndrome (PTS) can be a serious long-term consequence. Iliofemoral DVT should be associated with severe forms of PTS. Therefore an early thrombus removal has been recommended in specific conditions. The aim of this study was to find out both, the long-term results after surgical thrombectomy of iliofemoral DVT in respect of the development of PTS as well as the venous hemodynamics after surgery concerning venous reflux and venous obstruction. Methods Sixty-seven patients who underwent surgical thrombectomy between the years 2000 and 2014 were included in this study; iliofemoral DVT was present in 52 of these patients. 35 patients could be reinvestigated after a mean follow-up of 8.5 years. CEAP (Clinical-Etiological-Anatomical-Pathophysiological) and Villalta scores were recorded in order to describe and assess PTS. Follow-up examinations included a detailed duplex mapping. Venous hemodynamics were measured by digital photoplethysmography and venous occlusion plethysmography. Results The primary patency rate of the iliofemoral segment was 88% after 8.5 years. 48% of all patients showed reflux in deep vein segments. Mild or moderate PTS occurred in 57% of all patients. Notably, there was no patient with an active ulcer or severe PTS. The mean venous outflow volume of all patients in the treated legs was 66.1 ml/100ml/min and significantly less than in the controlled contralateral non-treated legs (p<0.05). The mean venous

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Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 97%

Surgical thrombectomy for iliofemoral deep vein thrombosis: Patient outcomes at 8.5 years

et al. 2020

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“…According to this case report, surgical glue removal was not successful due to the hard consistency of the glue and the associated risk of potential intraoperative complications such as vessel perforation, vessel rupture or pulmonary embolism [12]. Lindow et al [14] reported that the main determining factor in thrombectomy for iliofemoral thrombosis is the age of the thrombosis, since successful surgical removal of a thrombus is only possible up to a maximum thrombus age of ten days. Cyanoacrylate is a strong and fast-acting adhesive, thus even early surgical thrombectomy might not have been successful.…”

Section: Dear Editorsmentioning

confidence: 99%

Persistent iliac vein thrombosis after cyanoacrylate closure of the great saphenous vein

Gressenberger

Portugaller

Gütl

et al. 2020

J Deutsche Derma Gesell

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“…It is worthwhile to mention that the thrombectomy procedure was without any ballooning or stenting but with a flow stimulating a-v fistula created in the groin (31). A German center with great experience has published important results with surgical thrombectomy in 83 patients with iliofemoral DVT in 2010 (32). In the last patients of the series, the procedure was added with distally infused rtPA via a foot vein.…”

Section: Surgical Thrombectomymentioning

confidence: 99%

Update on early thrombus removal for iliofemoral deep vein thrombosis

Bækgaard

2019

Phlebologie

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Thrombus removal has for many years been attractive to investigate. The reasons were to relieve the acute symptoms with painful swelling and even to avoid tissue loss, but also with focus to decrease the incidence of late complications. Surgical procedures in the beginning and systemic thrombolysis years later were practiced in few dedicated centers. The breakthrough came 30 years ago in order to concentrate the lysis procedure directly into the thrombus material. This minimal invasive catheter-directed procedure was soon combined with stenting of the well-known iliac vein compression syndrome. Further development of this modality has taken place with some adjunctive mechanical devices primarily to minimize bleeding, which is the major concern of the methods. Less than ten RCT’s have been published over time, but conclusively supporting the rationale of early thrombus removal for iliofemoral DVT with reduction of PTS.

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Long-term Results after Transfemoral Venous Thrombectomy for Iliofemoral Deep Venous Thrombosis

Abstract: It is safe and effective to treat extensive iliofemoral DVT using transfemoral venous thrombectomy and this prevents the development of severe PTS in the long term. The procedure is only feasible in a subset of patients with DVT, depending on the extent and the age of the thrombosis.

Cited by 35 publications

References 14 publications

Surgical thrombectomy for iliofemoral deep vein thrombosis: Patient outcomes at 8.5 years

Surgical thrombectomy for iliofemoral deep vein thrombosis: Patient outcomes at 8.5 years

Persistent iliac vein thrombosis after cyanoacrylate closure of the great saphenous vein

Update on early thrombus removal for iliofemoral deep vein thrombosis

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