Vascular intervention plus arteriovenous fistula for the treatment of acute deep vein thrombosis of the lower extremities / 中国普通外科杂志

ABSTRACT

Objective To explore the appropriate method for mechanical thrombectomy, selection of vena cava filter and its duration in place. Method Fifty-five cases of severe acute deep vein thrombosis of the lower limbs were enrolled. Vena cava filter was first placed, then thrombectomy was performed with Amplatz thrombectomy device (ATD). The iliac vein lesions were dilated by balloon followed by temporary arterivenous fistula construction. Result Procedures were all successful in 52 cases, iliac vein stenosis was found in 47 cases and dilated by balloon. Permanent vena cava filters were placed in 20 cases while temporary in 32 cases. Fifty cases were followed-up for 3～30 monthes. Tumefaction disappeared in 46 cases leaving no after thrombosis syndrome. Conclusion This comprehensive modality is effective, less traumatic and of quick recovery. During the procedure, possible residual thrombi should always be under close attention and stenosis in iliac veins be confirmed by repeated venography. In most cases, placing a temporary vena cava filter was the best choice.