Etiologic spectrum in acute iliofemoral venous thrombosis

To identify common etiologies and allow a selective and effective management of acute iliofemoral venous thrombosis, 128 patients treated surgically (97 cases) or medically (31 patients) were analysed regarding possible underlying conditions. Chart review revealed that prolonged immobilization (25%), recent surgery (20%), and neoplasm (16%) were the most frequent etiologic factors. No underlying cause was detected in 34% of the patients, but more than one possible etiology were recorded in 29% of the patients. Chronic compression of the iliac vein was present in at least 13% of the operated cases. The multifactorial etiologic spectrum in iliofemoral thrombosis is basically the same as in calf vein thrombosis. Iliac vein compression, childbearing and perhaps estrogen intake seem to be more often associated with iliofemoral thrombosis. Initial survey regarding underlying causes permits tailored management for the individual patient. Surgical treatment is often successful but thrombi that develop secondary to chronic vein obstruction or neoplasm are preferably treated conservatively.