Results of iliofemoral venous thrombectomy after acute thrombosis: report on 165 cases.

Iliofemoral venous thrombosis may result in pulmonary embolism or a post-thrombotic syndrome. The incidence of pulmonary embolism after nonsurgical treatment is 10%, that of post-thrombotic syndrome 60%. The use of fibrinolysis is limited because of numerous contraindications. One hundred and sixty five iliofemoral venous thrombectomies were performed between 1976 and 1981. The patients ranged in age from 17 to 88 years (mean age 56). The postoperative mortality was 2.4%. One hundred and thirty four out of 165 patients were re-examined and 69 underwent phlebography. Over 70% were completely well. A post-thrombotic syndrome was present in four cases. The patency rate, phlebographically determined, was 60% at the popliteo-crural and iliofemoral level. In 32.5% a recanalized femoral vein with patent iliac vein was shown. Only in 5 cases a permanent occlusion of the iliofemoral vein was observed. Immediate thrombectomy in acute iliofemoral venous thrombosis has given excellent results. The incidence of pulmonary embolism and post-thrombotic syndrome was considerably reduced and good functional results were achieved.