Longterm Results After Surgical Thrombectomy and Simultaneous Stenting for Symptomatic Iliofemoral Venous Thrombosis

Abstract

Objectives: To evaluate the longterm outcome of venous thrombectomy and simultaneous stenting in patients with acute, symptomatic iliofemoral deep venous thrombosis (DVT). Methods: Between January 1996 and December 2007, a total of 45 patients underwent venous thrombectomy at our institution. Thrombectomy results were classified by intraoperative phlebography as: TYPE I = complete, TYPE II = partial, TYPE III = complete with stenosis other than thrombus, TYPE IV = permanent occlusion. TYPEs I and IV were excluded from this analysis because no endovascular repair was performed. 25 patients underwent a venous hybrid operation comprising balloon-catheter thrombectomy, thrombolysis and stenting of residual stensosis. Three TYPE 2 and 22 TYPE 3 lesions were diagnosed. Three patients died during follow-up from causes unrelated to their treatment. Three were lost to follow-up. Hence, 19 patients were examined. A retrospective, non comparative single-centre study was performed. Results: Median follow-up was 68 months (range 3–129). Primary and secondary patency rates were 74% (14/19) and 84% (16/19), respectively. Re-thrombosis occurred within seven days of operation in 26% (5/19). Procedure related mortality was zero. There was no case of late re-thrombosis. Four patients showed post-thrombotic sequelae (CEAP: C1, 2 or 3 s). No leg ulcer developed in any patient. Conclusion: Venous thrombectomy with simultaneous stenting results in excellent longterm results in selected patients with symptomatic iliofemoral venous thrombosis.