VENOUS THROMBECTOMY FOR ILIOFEMORAL VEIN-THROMBOSIS - 10-YEAR RESULTSOF A PROSPECTIVE RANDOMIZED STUDY

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.