Iliofemoral Venous Thrombectomy

Experience with iliofemoral venous thrombectomy in 45 cases has been reviewed. The indications for this procedure have been presented, and only two absolute contraindications are recognized. Certain aspects of surgical technique and of postoperative care have been discussed, with emphasis on the use of local anesthesia, the balloon catheter, and early postoperative ambulation. Results indicate that iliofemoral venous thrombectomy does relieve early morbidity and appears to be as successful as nonoperative management in the prevention of pulmonary embolism. Clinical improvement has been achieved in 76% of the entire group, and these results are influenced by both the preoperative duration of symptoms and the degree of success in removing the thrombus at operation. Of particular significance is a group of 14 patients followed for 2 or more years, only 14% of whom were afflicted by the sequelae of deep venous insufficiency. This finding provides encouraging support for the thesis that iliofemoral venous thrombectomy may ameliorate the late postphlebitic sequelae of deep venous thrombosis.