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Online ISSN 1827-1847
CONTROVERSIES IN VENOUS DISEASES
Department of Vascular Surgery, St.Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
In the last few years invasive recanalization techniques like venous thrombectomy or catheter-directed thrombolysis have regained popularity and are considered to be a valid treatment option for iliofemoral deep venous thrombosis (DVT). The reasons for this are that the recanalisation techniques have been refined and their complication rates reduced while at the same time their effectiveness was improved. Especially in the field of venous thrombectomy, the combination with intraoperative angioplasty and stenting of the pelvic veins as well as the use of intraoperative thrombolysis for the distal veins have made it possible to treat even extensive DVT´s involving the iliac veins and the vena cava from a small groin incision while still achieving complete recanalisation of the venous system. The technical aspects of modern venous thrombectomy are described, furthermore the medium and long-term outcome of the procedure is reported, based on personal results as well as a review of the literature.