Document Detail


Left iliac venous thrombosis caused by venous spur: treatment with thrombectomy and stent implantation.
MedLine Citation:
PMID:  9737459     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the frequency of iliac venous spurs in left iliofemoral venous thrombosis and to report the results of interventional management of venous spurs after transfemoral venous thrombectomy.
METHODS: From 1990 through 1996, 77 patients with acute iliac venous thrombosis (61 left and 16 right) underwent surgical treatment. Patients with malignant disease were excluded from this series. All patients had transfemoral venous thrombectomy with construction of an inguinal arteriovenous fistula and perioperative anticoagulation with heparin with a switch to warfarin sodium for at least 12 postoperative months. Immediate results of thrombectomy were documented by means of intraoperative completion venography. Arteriovenous fistulas were ligated 3 months after control arteriovenography. Since 1995 venous spurs eventually detected during thrombectomy were treated immediately by means of stent implantation.
RESULTS: Among 61 patients with left-sided thrombosis, intraoperative phlebography revealed common iliac venous obstruction suggestive of venous spurs in 30 patients (49%). In 16 of 22 patients (73%) with untreated spurs, postoperative rethrombosis of the iliac vein was documented despite adequate anticoagulation. Only one of eight patients (13%) with stented spurs had reocclusion (chi2 test P < .01).
CONCLUSION: Venous spurs are found among about half of patients with left-sided iliac venous thrombosis. As long as the underlying venous pathologic process is left untreated, thrombectomy will not restore patency. Stent implantation is a simple and safe means to correct central venous strictures and provides excellent long-term results.
Authors:
V Mickley; R Schwagierek; N Rilinger; J Görich; L Sunder-Plassmann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  28     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-09-25     Completed Date:  1998-09-25     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  492-7     Citation Subset:  IM    
Affiliation:
Department of Thoracic and Vascular Surgery, University of Ulm, Germany.
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / administration & dosage
Female
Heparin / administration & dosage
Humans
Iliac Vein / abnormalities,  pathology*
Middle Aged
Prosthesis Implantation*
Stents*
Thrombectomy*
Thrombosis / etiology*,  therapy*
Chemical
Reg. No./Substance:
0/Anticoagulants; 9005-49-6/Heparin

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