Endovenectomy of the common femoral vein and intraoperative iliac vein recanalization for chronic iliofemoral venous occlusion.

Chronic postthrombotic occlusion of the iliofemoral venous segments produces severe morbidity, which can be alleviated if venous drainage is restored. The common femoral vein (CFV) cannot always be fully recanalized with percutaneous endovenous techniques alone. We report the technique combining operative endovenectomy and patch venoplasty of the CFV with intraoperative iliac vein venoplasty and stenting to restore unobstructed venous drainage from the infrainguinal venous system to the vena cava.

Quantity of clot lysed after catheter-directed thrombolysis for iliofemoral deep venous thrombosis correlates with postthrombotic morbidity.

Background: International treatment guidelines now recognize the importance of thrombus removal to reduce postthrombotic morbidity when treating patients with extensive acute deep venous thrombosis (DVT). Studies have shown that thrombus resolution with catheter-directed thrombolysis in patients with iliofemoral DVT reduces postthrombotic morbidity, although patients unsuccessfully treated with catheter-directed thrombolysis (CDT) do not enjoy the same long-term benefit. The purpose of this study is to objectively assess whether the amount of clot reduction at the time of acute therapy correlates with long-term postthrombotic morbidity.