Semin intervent Radiol 2001; 18(2): 131-138
DOI: 10.1055/s-2001-15174
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Surgical Management of Iliofemoral Venous Thrombosis

Stephen G. Lalka
  • Department of Surgery, Division of Vascular Surgery, Indiana University School of Medicine, Wishard Memorial Hospital, Department of Surgery, Division of Vascular Surgery, Indianapolis, Indiana
Further Information

Publication History

Publication Date:
31 December 2001 (online)

ABSTRACT

Iliofemoral venous thrombosis (IFVT) is associated with a significant risk of death from pulmonary embolism, limb loss from venous gangrene, and the disabling sequelae of chronic venous insufficiency. To prevent such acute mortality and acute and chronic limb morbidity, treatment must be aggressive. Surgical venous thrombectomy (VT) has been shown to achieve long-term iliac vein patency with preservation of femoral-popliteal vein valve competence. VT has been a controversial procedure during the past 50 years. However, refinement of indications, addition of an adjunctive temporary arteriovenous fistula, and performance of this procedure as part of a protocol employing catheter-directed thrombolytic therapy have resulted in a valuable role for VT in the treatment of IFVT.

REFERENCES

  • 1 O'Donnell T F, Browse W L, Brunand K E, Thomas M L. Socioeconomic effects of an iliofemoral deep venous thrombosis.  J Surg Res . 1977;  22 483-488
  • 2 Strandness D E, Langlois Y E, Cramer M. Long-term sequelae of acute venous thrombosis.  JAMA . 1983;  250 1289-1292
  • 3 Mavor G E, Galloway J MD. Iliofemoral venous thrombosis: pathological considerations and surgical management.  Br J Surg . 1969;  56 45-59
  • 4 Rutherford R B. Pathogenesis and pathophysiology of the postthrombotic syndrome: clinical implications.  Semin Vasc Surg . 1996;  9 21-25
  • 5 Markel A, Manzo R, Bergelin R, Strandness D E. Valvular reflex after deep vein thrombosis: incidence and time of occurrence.  J Vasc Surg . 1993;  15 377-384
  • 6 Johnson B F, Manzo R A, Bergelin R O, Strandness D E. Relationship between changes in the deep venous system and the development of the post-thrombotic syndrome after an acute episode of lower limb deep venous thrombosis: a one-to-six year follow-up.  J Vasc Surg . 1995;  21 307-313
  • 7 Akesson H, Brudin L, Dahlstrom J D. Venous function assessed during a five-year period after acute iliofemoral venous thrombosis treated with anticoagulation.  Eur J Vasc Surg . 1990;  4 43-48
  • 8 Mahorner H. New management for thrombosis of deep veins of extremities.  Am Surg . 1954;  20 487-498
  • 9 Eklof B, Kistner R L. Is there a role for thrombectomy in iliofemoral venous thrombosis?.  Semin Vasc Surg . 1996;  9 34-45
  • 10 Haller J AJ, Abrams B L. Use of thrombectomy in the treatment of acute iliofemoral venous thrombosis in forty-five patients.  Ann Surg . 1963;  158 561-569
  • 11 Karp R B, Wylie E J. Recurrent thrombosis after iliofemoral venous thrombectomy.  Surg Forum . 1966;  17 147
  • 12 Lansing A M, Davis W M. Five-year follow-up study of iliofemoral venous thrombectomy.  Ann Surg . 1968;  168 620-628
  • 13 Plate G, Einarsson E, Ohlin P. Thrombectomy with temporary arteriovenous fistula: the treatment of choice in acute iliofemoral venous thrombosis.  J Vasc Surg . 1984;  1 867-876
  • 14 Einarsson E, Albrechtsson U, Eklof B. Thrombectomy and temporary AV-fistula in iliofemoral vein thrombosis-follow-up evaluation of venous morphology and function.  Surg Gynecol Obstet . 1986;  163 111-116
  • 15 Plate G, Akesson H, Einarsson E. Long-term results of venous thrombectomy combined with a temporary arterio-venous fistula.  Eur J Vasc Surg . 1990;  4 483-489
  • 16 Neglen P, al-Hassan H K, Endrys J. Iliofemoral venous thrombectomy followed by percutaneous closure of the temporary arteriovenous fistula.  Surgery . 1991;  110 493-499
  • 17 Juhan C M, Alimi Y S, Barthelemy P J. Late results of iliofemoral venous thrombectomy.  J Vasc Surg . 1997;  25 417-422
  • 18 Walsh D B, Juravsky L I, Cronenwett J L. Thrombothrombolytic therapy for acute deep venous thrombosis. In: Strandness DE, vanBreda A, eds. Vascular Diseases: Surgical and Interventional Therapy New York: Churchill Livingstone 1994: 895-904
  • 19 Rutherford R B. Role of surgery in iliofemoral venous thrombosis.  Chest . 1986;  5(Suppl) 434S-437S
  • 20 Comerota A J, Aldridge S C, Cohen G. A strategy of aggressive regional therapy for acute iliofemoral venous thromboses with contemporary venous thrombectomy or catheter-directed thrombolysis.  J Vasc Surg . 1994;  20 244-254
  • 21 Meissner A J, Huszcza S. Surgical strategy for management of deep venous thrombosis of the lower extremities.  World J Surg . 1996;  20 1149-1155
  • 22 Eklof B, Juhan C. Revival of thrombectomy in the management of acute iliofemoral venous thrombosis.  Contemp Surg . 1992;  40 21-30
  • 23 Masuda E M, Kistner R L, Ferris E B. Long-term effects of superficial femoral vein ligation: thirteen-year follow-up.  J Vasc Surg . 1992;  16 741-749
  • 24 Lalka S G. Venous bypass grafts for chronic venous occlusive disease. In: Gloviczki P, Yao JST, eds. Handbook of Venous Disorders London: Chapman & Hall 1996: 446-470
  • 25 Endrys J, Eklof B, Neglen P. Percutaneous balloon occlusion of surgical arteriovenous fistulae following venous thrombectomy.  Cardiovasc Intervent Radiol . 1989;  12 226-229
  • 26 Lalka S G, Lash J M, Unthank J L. Inadequacy of saphenous vein grafts for cross-femoral venous bypass.  J Vasc Surg . 1991;  13 622-630
  • 27 Plate G, Eklof B, Norgren L. Venous thrombectomy for iliofemoral vein thrombosis-10 year results of a prospective randomized study.  Eur J Vasc Endovasc Surg . 1997;  14 367-374
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