long-term outcome of transfemoral thrombectomy in patients with acute iliofemoral vein thrombosis

abstract background: the optimal therapy of acute iliofemoral venous thrombosis is still a matter of debate. the purpose of our study was to evaluate the late results of iliofemoral thrombectomy with regard to the prevention of the development of a post thrombotic syndrome (pts). methods: during 2000-2003, 18 patients underwent transfemoral venous thrombectomy for acute iliofemoral venous thrombosis. 16 patients were reexamined after a 5-year follow-up. at follow-up, the patency of venous segments as well as the development of reflux was investigated by duplex-ultrasound. furthermore, clinical signs and symptoms of pts in patients were recorded. results: clinical pulmonary emboli did not occur in the perioperative period. two patients died because of disseminated metastatic cancer and another after massive retroperitoneal bleeding due to anticoagulation therapy. in a 5-year follow up, 31% had valvular reflux. venous patency rate was 75%. the rate of pts was 37.5% without the severe form of pts. patients did not have healed, healing, and/or active venous ulcer. conclusion: it is thought that vein patency and valvular function were relatively restored, and pts was prevented after surgical thrombectomy. vascular surgeons should include venous thrombectomy as a part of their routine operative armamentarium, offering this procedure to patients with iliofemoral dvt, especially if other options are not available or have failed.