[Treatment of iliofemoral venous thrombosis]

In a series of 41 patients with iliofemoral venous thrombosis, 23 were treated with heparin only. Five patients received ultra high dose streptokinase without any detectable thrombolysis. 11 patients were treated according to the conventional dose regimen for streptokinase. Three of these obtained complete thrombolysis, and two partial thrombolysis. Two patients were treated primarily with thrombectomy, whereas five patients were referred to thrombectomy after streptokinase had failed. Operation resulted in complete recanalization in four cases, and partial recanalization in two cases. We recommend the conventional dose regimen for streptokinase as first-line therapy for iliofemoral venous thrombosis. Thrombectomy should be considered if phlegmasia cerulea dolens is present, or when streptokinase is contraindicated. Thrombectomy can be carried out equally well after streptokinase failure, if major symptoms last less than a week.