Ann Vasc Med | Volume 1, Issue 1 | Research Article | Open Access
Igor M Ignatyev*
Department of Vascular Surgery, Interregional Clinical and Diagnostic Center, Russia
*Correspondance to: Igor M IgnatyevFulltext PDF
Background: To assess the effectiveness of open thrombectomy in acute iliofemoral venous thrombosis.
Methods: Between January 2012 and December 2016, a total of 37 patients underwent transfemoral venous thrombectomy in acute iliofemoral venous thrombosis. Six patients underwent a venous hybrid operation comprising ballon-catheter thrombectomy and stenting of residual stenosis of iliac veins. The control group consists of 24 patients who received standard anticoagulant therapy. The results were evaluated by duplex ultrasound. The assessment of clinical effectiveness was made with Venous Clinical Severity Score (VCSS) and Clinical- Etiologic - Anatomic - Pathophysiologic (CEAP) classification.
Results: Patency of iliofemoral segment at 6 months of monitoring after thrombectomy was reported in 92% of cases. Meanwhile, the recanalization of iliofemoral segment was registered only in 21% (5/24; X2=31, P=0.00001) of patients, who had anticoagulant therapy. Recanalization of femoropopliteal veins at 6 months after the thrombectomy was reported in 70% cases (23/33). The median preoperative VCSS was 7, which dropped to 2 at 6 months (P=0.002). The cumulative patency rate of iliofemoral veins at 36 months was 86%; 38% (8/21) of surgical patients had normal venous function of distal popliteal and tibial veins in conformity with the results of duplex scanning at three years. According to CEAP classification, 90% (19/21) of patients had no or mild symptoms of postthrombotic syndrome (PTS) after thrombectomy.
Conclusion: In accordance with selective indications, open thrombectomy in iliofemoral venous thrombosis with using current methods of deep veins patency reconstruction increases the effectiveness of treatment of this severe pathology and prevent from progression of PTS.
Acute Iliofemoral Venous Thrombosis; Open Thrombectomy; Stenting; Recanalization; Duplex Ultrasound
Ignatyev IM. Open Thrombectomy in Acute Iliofemoral Venous Thrombosis. Annals Vasc Med Surg. 2018;1(1):1001.