Outcomes of Surgical Thrombectomy for ILIO-Femoral Deep Vein Thrombosis in Hospitals in Rivers State

Abstract

Background: In patients presenting with Deep Vein Thrombosis (DVT) involving the ilio-femoral veins, pulmonary embolism and post-thrombotic syndrome are major concerns. Intervening early by removing the venous thrombus significantly reduces the burden of DVT. Objective: To assess recanalization, post-procedure development of pulmonary embolism (PE) and or post thrombotic syndrome (PTS) following surgical thrombectomy for ilio-femoral DVT. Materials and Methods: This is a descriptive cross-sectional study that was conducted at a public and five private healthcare facilities in Port Harcourt with data prospectively collected from March 1, 2018, to February 29, 2024 that evaluated the outcomes of surgical thrombectomy for DVT involving the ilio-femoral veins. Those with strictly below knee (popliteal vein) DVT were excluded from the study, as they were treated mainly by non-surgical means. A pre-designed semi-structured questionnaire was used to obtain variables which included patients’ demography, veins involved, type of DVT, surgical approach, type of anesthesia and outcome. Results are presented as frequencies, tables, and figures. The statistical level of significance was set as p value of ≤ 0.05. Results: The study involved 19 patients who had surgical thrombectomy during the period under review. There were 12 (63.16%) males and 7 (36.84%) female patients. The age range was 22 to 78years. Of these, 8 (42.10%) patients had femoral or ilio-femoral DVT alone, while 11 (57.90%) patients had calf vein DVT in addition to femoral or ilio-femoral DVT. 16 patients had acute DVT and 3 patients presented with acute-on-chronic DVT. Surgical thrombectomy was done with the aid of fogarty catheters in all cases. All the patients had combined epidural and spinal anesthesia. Recanalization was achieved in all 19 cases, no clinical PE was detected peri-operatively, however, the patients with acute on chronic DVT had significant PTS. Conclusion: The safety profile and recanalization rate following surgical thrombectomy for iliofemoral DVT is very good especially when done at the acute phase of the DVT. This also significantly prevents the occurrence of post thrombotic syndrome.