Summary
Between 1977 and 1986, 185 patients with deep venous thrombosis (117 with acute occlusive and 68 with embolizing deep venous thrombosis) underwent venous thrombectomy with arterio-venous fistula. The early patency rate was 96%, and the perioperative mortality rate, 3.8%.
Of the 157 patients in whom extremities were involved, 147 were examined 12–118 months postoperatively (mean 43±23 months) clinically, by Doppler ultrasound and by light reflexion rheography (LRR). In 49% of the patients, various kinds of swelling or oedema of the involved extremities were present. There were no hemodynamical disturbances in 53% (LRR-examination); competent venous valves were found in 44%. According to the severity of symptoms and hemodynamical findings, postthrombotic syndrome was absent in 47%, mild in 20%, moderate in 28%, and severe in 5% (7 patients, 4 with venous ulcers). Six of the 7 patients with severe postthrombotic syndrome belonged to the group operated for embolizing thrombosis, where no selection of cases was performed. The best long-term results were achieved in patients operated for acute occlusive thrombosis of the iliac and iliofemoral veins.
Venous thrombectomy with av fistula can achieve sufficient early and long-term results in the treatment of deep venous thrombosis, provided strict selection of patients and a meticulous technique are practised.
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Abbreviations
- av-Fistel:
-
Arterio-venöse Fistel
- LE:
-
Lungenembolie
- LRR:
-
Lichtreflexionsrheographie
- PPG:
-
Photoplethysmographie
- PTS:
-
Postthrombotisches Syndrom
- TVT:
-
Tiefe Venenthrombose
- USD:
-
Ultraschall-Dopplersonographie
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Kniemeyer, H.W., Merckle, R., Stühmeier, K. et al. Chirurgische Therapie der akuten und embolisierenden tiefen Beinvenenthrombose — Indikation, Technisches Prinzip, Ergebnisse. Klin Wochenschr 68, 1208–1216 (1990). https://doi.org/10.1007/BF01796511
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DOI: https://doi.org/10.1007/BF01796511