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2 . 2022

Surgical thrombectomy for treatment of acute iliofemoral venous thrombosis


Background. Deep vein thrombosis of the lower extremities is one of the most common vascular diseases, which is accompanied by the development of such severe complications as pulmonary embolism and post-thrombotic syndrome.

Aim – to assess the effectiveness of open surgical thrombectomy in acute iliofemoral venous thrombosis.

Material and methods. The prospective cohort study included 65 patients, who underwent transfemoral venous thrombectomy (VT) in acute iliofemoral venous thrombosis. 10 patients received  a venous hybrid operation comprising balloon-catheter thrombectomy and stenting of residual stenosis of iliac vein. The control group consisted of 44 patients who received standard anticoagulant therapy. The results were evaluated by duplex ultrasound. The assessment of clinical effectiveness was made with Venous Clinical Severity Score, Villalta Score and Chronic Venous Insufficiency Questionnaire.

Results. Secondary patency of iliofemoral segment at 6 months of monitoring after thrombectomy was reported in 97% of cases. Meanwhile, the recanalization of iliofemoral segment was registered only in 27% (p<0.0001) of patients who had anticoagulant therapy alone. The median preoperative VCSS was 7, which dropped to 2 at 6 months (p=0.002). There were 5 cases of successful re-thrombectomy and stenting (3 cases). Сumulative primary and secondary patency rates  of iliofemoral veins at 72 months were 88 and 95%, respectively. The data Villalta score in long-term follow-up in patients after surgery was significantly lower than in patients treated with anticoagulation (p<0.001). Quality of life of patients of patients after 6 years of VT was improved, its mean score decreased from 45.3 (8.6) to 23.6 (6.1); p<0.001.

Conclusion. According to selective indications open surgical thrombectomy in iliofemoral venous thrombosis with using current methods of deep vein restoration patency increases the effectiveness of treatment of this severe pathology and prevents from progression of postthrombotic syndrome.

Keywords:acute iliofemoral venous thrombosis; open surgical thrombectomy; stenting; post-thrombotic syndrome; duplex ultrasound examination

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Ignatyev I.M., Evseeva V.V., Gradusov E.G. Surgical thrombectomy for treatment of acute iliofemoral venous thrombosis. Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (2): 60–9. DOI: (in Russian)


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Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)
Medicine today

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