Deep vein thrombosis surgery
Editor(s)-In-Chief: The APEX Trial Investigators, C. Michael Gibson, M.S., M.D. ; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D.  ; Kashish Goel, M.D.; Assistant Editor(s)-In-Chief: Justine Cadet
Deep Vein Thrombosis Microchapters
Deep vein thrombosis surgery On the Web
Operative venous thrombectomy can be considered for the treatment of iliofemoral deep vein thrombosis (DVT), mainly when catheter directed thrombolysis (CDT) and pharmacomechanical catheter directed thrombolysis (PCDT) can not be performed.
A single small randomized controlled trial showed that operative venous thrombectomy and anticoagulation therapy may lead to better iliac vein patency and less post-thrombotic syndrome as compared to anticoagulation therapy alone. Operative venous thrombectomy is invasive and requires general anesthesia. It also carries a small risk of pulmonary embolism. Operative venous thrombectomy should be considered only if all of the following criteria are met:
- Iliofemoral DVT
- Symptoms < 7 days
- Good functional status
- Life expectancy ≥1 year
2012 American College of Chest Physicians Evidence-Based Clinical Practice Guidelines on Antithrombotic Therapy for VTE Disease: Antithrombotic Therapy and Prevention of Thrombosis (DO NOT EDIT)
Treatment of Acute DVT
|"1. In patients with acute proximal DVT of the leg, we suggest anticoagulant therapy alone over operative venous thrombectomy (Level of Evidence: C)."|
2011 AHA Scientific Statement-Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension (DO NOT EDIT)
Recommendations for Endovascular Thrombolysis and Surgical Venous Thrombectomy (DO NOT EDIT)
|"1. Surgical venous thrombectomy by experienced surgeons may be considered in patients with IFDVT (Level of Evidence: B)."|
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- Plate G, Eklöf B, Norgren L, Ohlin P, Dahlström JA (1997). "Venous thrombectomy for iliofemoral vein thrombosis--10-year results of a prospective randomised study". Eur J Vasc Endovasc Surg. 14 (5): 367–74. PMID 9413377.
- Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ; et al. (2011). "Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association". Circulation. 123 (16): 1788–830. doi:10.1161/CIR.0b013e318214914f. PMID 21422387.