Open surgery for iliofemoral deep vein thrombosis with temporary arteriovenous fistula remains valuable

Phlebology. 2018 Oct;33(9):600-609. doi: 10.1177/0268355517736437. Epub 2017 Oct 24.

Abstract

Objective We assessed outcomes of open surgical venous thrombectomy with temporary arteriovenous fistula, and the procedure's effect on health-related quality of life. Method We retrospectively analyzed 48 (26 at long-term) patient medical records. Mortality rates, patency, and risk of post-thrombotic syndrome were analyzed using Kaplan-Meier estimation. The association between risk factors/coagulation disorders and patency/post-thrombotic syndrome along with patient health-related quality of life at long-term was analyzed employing various statistical methods. Results Patient one-year survival rate was 93 ± 4% and primary one-year patency rate was 89 ± 5% (secondary one-year patency rate 97 ± 3%). Freedom from post-thrombotic syndrome after eight years was 80 ± 12% (post-thrombotic syndrome rate 20 ± 12%). Health-related quality of life was impaired vs. normative data in the physical and social subscales, and in the mental component score ( p < .05). Conclusions Open surgical venous thrombectomy appears safe compared with literature-reported outcomes in similar patients using alternative approaches. Iliofemoral deep vein thrombosis impairs physical, social, and mental health-related quality of life.

Keywords: Deep vein thrombosis; duplex ultrasound; post-thrombotic syndrome; quality of life assessment; surgery.

Publication types

  • Clinical Trial

MeSH terms

  • Anastomosis, Surgical
  • Disease-Free Survival
  • Female
  • Femoral Vein / surgery*
  • Humans
  • Iliac Vein / surgery*
  • Male
  • Middle Aged
  • Survival Rate
  • Thrombectomy / adverse effects
  • Thrombectomy / methods*
  • Venous Thrombosis / mortality*
  • Venous Thrombosis / surgery*