DIAGNOSTIC-IMPORTANCE OF VASCULAR ENDOSCO PY IN VENOUS THROMBECTOMY

Since 1983 angioscopy was applied as a control method in 187 venous th rombectomies to improve the treatment of acute iliofemoral thrombosis. In a retrospective study we tried to show the impact of angioscopy in traoperatively and the influence on long-term results. Thrombectomy wa s performed in 97 patients affected at three levels, in 50 cases with pelvic-femoral, in 35 with pelvic and in 43 with femoro-tibial thrombo sis. The average clinical age of the thrombosis was 5 days, 66% of the patients (age 39 years) were female. The endoscopic findings were com pared with phlebological results after one year using a phleboscore be tween 0 points ( occlusion) and 5 points (normal). The phlebographies were analyzed so that the functional status of the vein was represente d. After venous thrombectomy 42.8% of the cases were endoscopically cl assified complete but in 57.2% residual clots were observed. It was po ssible to completely (24.6%) or partly (18.7%) remove these clots by f urther thrombectomy maneuvers, non removable remnants were found in 7. 5% and a venous spur in 6.4%. The statistical analysis with Kruskal- W allace test showed significant differences in venous morphology betwee n the endoscopically complete thrombectomies and those with residual c lots. After a follow-up period of 30 months (12-64) the clinical resul ts were very good. In 58% we observed normal findings, a cvi grade I i n 35%, grade II in 4%. Crural ulcers had developed in only 3%. From ou r data we conclude that endoscopy is an excellent method for intraoper ative quality-control in venous thrombectomy.