Document Detail

Long-term results of venous thrombectomy combined with a temporary arterio-venous fistula.
MedLine Citation:
PMID:  2226879     Owner:  NLM     Status:  MEDLINE    
Forty-one patients with acute iliofemoral venous thrombosis were randomised to conventional anticoagulation or acute thrombectomy combined with a temporary arterio-venous fistula (AVF) and anti-coagulation. Follow-up after 5 years in 22 medical and 19 surgical patients revealed slightly more asymptomatic patients (37 vs. 18%) and less frequent severe post-thrombotic sequelae (16 vs. 27%) in the surgical group (N.S.). The iliac vein was more frequently (P less than 0.05) normal following thrombectomy (71 vs. 30%) as demonstrated by radionuclide angiography, but occlusion plethysmography showed an outflow capacity (61 vs. 45 ml/min/100 ml) that was not significantly better. There was no obvious difference in muscle pump function (EVrel) and reflux (Q/EVrel) assessed by foot volumetry. Still, the ambulatory venous pressure was significantly (P less than 0.05) lower in the surgical group. There was a tendency towards better results following thrombectomy in patients with fresh thrombosis and a successful initial procedure. Although the numbers of observations in many cases were too small to provide statistical evidence of benefit with venous thrombectomy + AVF, this procedure seems to improve the long-term outcome following acute iliofemoral venous thrombosis. Since the difference in outcome is not very striking, anticoagulation treatment is still an acceptable alternative.
G Plate; H Akesson; E Einarsson; P Ohlin; B Eklöf
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of vascular surgery     Volume:  4     ISSN:  0950-821X     ISO Abbreviation:  Eur J Vasc Surg     Publication Date:  1990 Oct 
Date Detail:
Created Date:  1990-12-12     Completed Date:  1990-12-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8709440     Medline TA:  Eur J Vasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  483-9     Citation Subset:  IM    
Department of Surgery, Central Hospital, Helsingborg, Sweden.
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MeSH Terms
Acute Disease
Anticoagulants / therapeutic use
Arteriovenous Shunt, Surgical*
Femoral Artery / surgery
Femoral Vein* / radionuclide imaging
Iliac Vein* / radionuclide imaging
Leg / blood supply
Middle Aged
Postoperative Complications
Prospective Studies
Radionuclide Angiography
Regional Blood Flow
Saphenous Vein / surgery
Thrombosis / complications,  drug therapy,  radionuclide imaging,  surgery*
Reg. No./Substance:

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