Surgical treatment of iliofemoral vein thrombosis technical aspects. Possible secondary interventions

From October 1982 to February 1989 148 patients underwent venous thrombectomy. Priority for surgery was given especially in patients under 40 years with posttraumatic, postoperative and postpartum thrombosis where lysis was not possible. Our standardized operative technique includes atraumatic exposure of the vessels, clot extraction by balloon catheter and ring stripper, endoscopic control of the lumen and establishment of a temporary arteriovenous fistula. Postoperative angiography revealed that more than 10% of the patients needed secondary dilatation of iliac vein stenosis which can be carried out easily at the time of closing the fistula. Functional and anatomical parameters as well as the clinical outcome after 12 months show good to excellent results which confirm venous thrombectomy as a useful treatment modality at an acceptable risk level.