Surgical Thrombectomy Followed by Intraoperative Endovascular Reconstruction for Symptomatic Ilio-femoral Venous Thrombosis

Abstract

Ilio-caval venous obstructions detected intraoperatively can be reconstructed in a one-stage combined procedure. The specific endovascular approach depends on the type of residual venous obstruction. Excellent mid-term results indicate that the proposed thrombectomy classification (TYPE I-IV) and treatment algorithm optimises the results in selected patients with symptomatic venous thrombosis.

Late results of surgical venous thrombectomy with iliocaval stenting

“…With a median of 63 months, we report the longest follow-up after such procedures, to our knowledge. Our results are consistent with those of the literature regarding surgical venous thrombectomy with stenting of iliac obstruction 4,19,[30][31] and are comparable with those we had in a former report, 3 including patients with or without obstructive lesions. It is not possible to compare these long-term results with those of thrombolysis because all authors but one report follow-up of only 12 months.…”

“…Surgical thrombectomy also provided a high technical success rate (always Ͼ95% in the literature), which overtakes those of thrombolysis (Table II), [22][23][24][25][26][27][28][29] but patency rates at 1 year are similar for both approaches (Table III). [22][23][24][25][26][27][28][29][30][31] Various contraindications limit the applicability of percutaneous techniques, which was 75% in our previously published experience, 3 and 38% in this report. Contraindications to the adjunctive stenting are sepsis (if not also a contraindication to venous thrombectomy) and pregnancy.…”

Symptomatic ileofemoral DVT after onset of oral contraceptive use in women with previously undiagnosed May-Thurner Syndrome

“…Angioplasty and endovascular stenting of the obstruction has proven to be the most efficacious therapy in this population. [13][14][15][16][17][18][19][20][21][22] Failure to diagnosis this condition predisposes these women to the unnecessary risks of recurrent DVT and post-thrombotic syndrome. …”

Transcatheter recanalization of ligated main pulmonary artery

“…Transcatheter recanalization of peripheral and central veins, arteries, or surgically created shunts or baffles has been performed in selected patients and conditions in the past [1–6]. Such vessel occlusions are related to luminal thrombosis or intimal proliferation.…”