caa a22 4500 477034969 CHVBK 20180405111302.0 cr unu---uuuuu 170330e19961101xx s 000 0 eng 10.1007/s002689900175 doi (NATIONALLICENCE)springer-10.1007/s002689900175 Surgical Strategy for Management of Deep Venous Thrombosis of the Lower Extremities [Elektronische Daten] [Alfred J. Meissner, Sławomir Huszcza] Abstract. Clinical experience proves that there is a considerable group of patients with acute proximal deep vein thrombosis (DVT) of the legs who have absolute or relative contraindications to anticoagulants or thrombolytic agents but require immediate medical treatment. The aim here is to present our strategy for qualifying patients for venous thrombectomy and the technique of the operation in patients with acute iliofemoral DVT. A total of 268 patients with DVT were evaluated. A proximal thrombosis was diagnosed in 225 cases (84%), and acute thrombosis was found in 126 (56%) of these 225 patients. Venous thrombectomy with temporary arteriovenous fistula was performed in 30 patients. In the remaining patients initial treatment included heparin, acenocumarol, or both in 61, thrombolytic agents in 26, and other therapy in 9 cases. Three patients died during the early postoperative period. Minor nonhemorrhagic complications were observed in four operated patients. One patient developed wound hematoma. In all but three operated cases the patency of the iliac and femoral veins with leg swelling in 16 patients was observed 1 year after fistula closure. There were no episodes of rethrombosis during this period. None of the thrombectomized patient had leg ulcers. Eight patients were free of clinical symptoms related to DVT. We believe that venous thrombectomy provides a good chance for satisfactory restoration of venous outflow in patients with acute proximal DVT. Venous thrombectomy with temporary arteriovenous fistula represents the treatment of choice in patients with acute, proximal DVT and with contraindications to heparin treatment.: 1996 by the Société Internationale de Chir, ugie Meissner Alfred J. Department of Surgery, Institute of Hematology and Blood Transfusion, Chocimska 5, 00 957 Warsaw, Poland, PL aut Huszcza Sławomir Department of Surgery, Institute of Hematology and Blood Transfusion, Chocimska 5, 00 957 Warsaw, Poland, PL aut https://doi.org/10.1007/s002689900175 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900175 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Meissner Alfred J. Department of Surgery, Institute of Hematology and Blood Transfusion, Chocimska 5, 00 957 Warsaw, Poland, PL aut NATIONALLICENCE 700 1- Huszcza Sławomir Department of Surgery, Institute of Hematology and Blood Transfusion, Chocimska 5, 00 957 Warsaw, Poland, PL aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer