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

In 125 cases surgically treated for thrombophlebitis of the lower limbs, thrombectomy was done in 96, while caval clipping alone was done in 31. Beginning in 1965, technical improvements and systematic control of the 3 major cross points of the lower limb venous system resulted in gradually improved results as regards patency rate and clinical status. When the return flow was increased by arteriovenous fistula, the patency rate and the clinical results were significantly improved. Comparison of a first group of 23 patients submitted to venous thrombectomy alone with 102 patients protected by filters or serrated clips shows a drastic decrease in lethal pulmonary embolism postoperatively. Mortality in the unprotected group was 8.7% while in the protected series it fell to .98%: the latter death was in fact due to forced selection of an operation of second choice. In the protected series, 69 preoperative pulmonary embolisms were recorded in 55 patients. Only one minor postoperative embolism occurred, this originating from an axillary phlebitis. We find caval clipping to be formally indicated whether or not a venous disobstruction procedure is feasible.