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[Thrombectomy after unsuccessful thrombolytic therapy of deep leg vein thromboses: an effective procedure?]
H Stiegler1, E Hiller, H Arbogast
1Chirurgische Klinik und Poliklinik, Klinikum Grosshadern, Universität München.
Abstract:
Lysis of acute thromboses of the pelvic and deep lower leg veins is not always successful. According to the literature, 11-20% of the cases remain occluded. In such cases the majority of authors continue therapy with anticoagulants (heparin, dicumarol). 31 thromboses which had been unsuccessfully treated by lysis were subsequently thrombectomized after a few hours. All external iliac veins could be opened. The amount of occluded common iliac veins could be reduced from 94% to 16%. In 19% a stenosis due to a venous spur remained. The complete patency rate of the extremity veins could be improved by 55%. This shows that a marked improvement of the primary patency rate could be reached despite the failed lysis. This is a prerequisite of a favourable longtime result. An evaluation of the late results is planned and will be published at a later date.