G. Plate et al., VENOUS THROMBECTOMY FOR ILIOFEMORAL VEIN-THROMBOSIS - 10-YEAR RESULTSOF A PROSPECTIVE RANDOMIZED STUDY, European journal of vascular and endovascular surgery, 14(5), 1997, pp. 367-374
Objectives: To study if venous thrombectomy prevents late post-thrombo
tic sequelae, venous obstruction reflux, and improves venous physiolog
y following an acute iliofemoral nl venous thrombosis. Design: Prospec
tive randomised controlled study. Material: Thirty patients returned f
or follow-up 10 years after an acute iliofemoral venous thrombosis ini
tially treated with conventional anticoagulation treatment (medical gr
oup, n=17) or with thrombectomy combined with a temporary arteriovenou
s fistula and anticoagulation (surgical group, n = 13). Clinical asses
sment, radionuclide angiography, duplex ultrasound and venous physiolo
gy tests were performed. Results: Leg swelling was recorded in 12 (71%
) and leg ulcers in three (18%) of the medical patients and in, respec
tively, sh (46%) and one 18%) of the surgical patients. The surgical p
atients had less severe sequelae (class 0-2). Radionuclide angiography
demonstrated that the iliac vein tons more commonly occluded followin
g medical (59%) than following surgical (17%) treatment (p<0.05). Dupl
ex examination demonstrated slightly (n.s.) more reflux in the femoral
and popliteal veins in the medical group. Venous physiology (occlusio
n plethysmography, foot volumetry, and foot vein pressures) did not sh
ow any significant differences, although the medical group tended to h
ave a more severe pathology. Conclusion: Venous thrombectomy improves
venous patency and possibly reduces venous reflux and post-thrombotic
sequelae as compared to anticoagulation treatment.