Venous thrombectomy for iliofemoral vein thrombosis - 10-year results of a prospective randomised study

被引:167
作者
Plate, G
Eklof, B
Norgren, L
Ohlin, P
Dahlstrom, JA
机构
[1] Department of Surgery, Helsingborg Hospital
关键词
venous thrombosis; iliofemoral vein thrombosis; venous thrombectomy; anticoagulation treatment; randomised controlled trial (RCT);
D O I
10.1016/S1078-5884(97)80286-9
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objectives: To study if venous thrombectomy prevents late post-thrombotic sequelae, venous obstruction reflux, and improves venous physiology following an acute iliofemoral nl venous thrombosis. Design: Prospective randomised controlled study. Material: Thirty patients returned for follow-up 10 years after an acute iliofemoral venous thrombosis initially treated with conventional anticoagulation treatment (medical group, n=17) or with thrombectomy combined with a temporary arteriovenous fistula and anticoagulation (surgical group, n = 13). Clinical assessment, radionuclide angiography, duplex ultrasound and venous physiology tests were performed. Results: Leg swelling was recorded in 12 (71%) and leg ulcers in three (18%) of the medical patients and in, respectively, sh (46%) and one 18%) of the surgical patients. The surgical patients had less severe sequelae (class 0-2). Radionuclide angiography demonstrated that the iliac vein tons more commonly occluded following medical (59%) than following surgical (17%) treatment (p<0.05). Duplex examination demonstrated slightly (n.s.) more reflux in the femoral and popliteal veins in the medical group. Venous physiology (occlusion plethysmography, foot volumetry, and foot vein pressures) did not show any significant differences, although the medical group tended to have a more severe pathology. Conclusion: Venous thrombectomy improves venous patency and possibly reduces venous reflux and post-thrombotic sequelae as compared to anticoagulation treatment.
引用
收藏
页码:367 / 374
页数:8
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