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Open surgery for iliofemoral deep vein thrombosis with temporary arteriovenous fistula remains valuable

Markus U Wagenhäuser1,2, Hellai Sadat1, Philip Dueppers1

  • 11 Department of Vascular and Endovascular Surgery, University Hospital of Düsseldorf, Düsseldorf, Germany.

Phlebology
|October 26, 2017
PubMed

Insights

Open surgical venous thrombectomy is a safe procedure for iliofemoral deep vein thrombosis, showing good long-term patency. However, it significantly impacts patients' physical, social, and mental quality of life.

Area of Science:

  • Vascular Surgery
  • Thrombosis Management
  • Quality of Life Research

Background:

  • Deep vein thrombosis (DVT) of the iliofemoral system can lead to significant morbidity.
  • Post-thrombotic syndrome (PTS) is a common complication, impacting quality of life.
  • Surgical venous thrombectomy is an alternative treatment option for selected DVT cases.

Purpose of the Study:

  • To evaluate the outcomes of open surgical venous thrombectomy with a temporary arteriovenous fistula.
  • To assess the procedure's impact on health-related quality of life (HRQoL) in patients with iliofemoral DVT.

Main Methods:

  • Retrospective analysis of 48 patient medical records (26 long-term follow-up).
  • Kaplan-Meier estimation for mortality, patency, and PTS rates.
  • Statistical analysis of risk factors, coagulation disorders, and HRQoL.

Main Results:

  • One-year survival rate: 93%.
  • Primary one-year patency rate: 89%; secondary: 97%.
  • Eight-year freedom from PTS: 80%; PTS rate: 20%.
  • HRQoL was impaired in physical, social, and mental domains compared to normative data (p < .05).

Conclusions:

  • Open surgical venous thrombectomy demonstrates favorable safety and patency outcomes compared to alternative treatments.
  • Iliofemoral DVT significantly impairs patients' physical, social, and mental HRQoL.
  • Surgical thrombectomy may be a viable option, but long-term quality of life deficits require attention.

Keywords:
Deep vein thrombosisduplex ultrasoundpost-thrombotic syndromequality of life assessmentsurgery

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