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Venous thrombectomies and partial interruption of the vena cava in 125 cases of thrombophlebitis

L Van de Berg

    The Journal of Cardiovascular Surgery
    |March 1, 1978
    PubMed

    Insights

    Surgical treatment for lower limb thrombophlebitis significantly reduced lethal pulmonary embolism with caval clipping, improving patient outcomes and venous patency. Arteriovenous fistulas further enhanced results.

    Area of Science:

    • Vascular Surgery
    • Cardiovascular Medicine
    • Thromboembolic Disease Management

    Background:

    • Thrombophlebitis of the lower limbs presents a significant risk of pulmonary embolism.
    • Surgical interventions aim to improve venous patency and reduce embolic complications.

    Purpose of the Study:

    • To evaluate the efficacy of thrombectomy and caval clipping in managing lower limb thrombophlebitis.
    • To assess the impact of technical improvements and adjunctive procedures on surgical outcomes.

    Main Methods:

    • Analysis of 125 cases surgically treated for lower limb thrombophlebitis.
    • Comparison of outcomes between thrombectomy, caval clipping, and combined approaches.
    • Evaluation of the role of arteriovenous fistulas and caval filters/clips in preventing pulmonary embolism.

    Main Results:

    • Technical improvements since 1965 led to better patency rates and clinical status.
    • Arteriovenous fistulas significantly improved venous patency and clinical results.
    • Caval clipping (filters or serrated clips) drastically reduced lethal pulmonary embolism from 8.7% to 0.98%.

    Conclusions:

    • Caval clipping is indicated for lower limb thrombophlebitis, regardless of the feasibility of venous disobstruction procedures.
    • Surgical management, particularly with caval protection, significantly lowers mortality from pulmonary embolism.
    • Optimized surgical techniques enhance venous patency and overall patient recovery.

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