Management of Ilio-Femoral Deep Vein Thrombosis: A Hybrid Approach
Anastasia Dean*, Swee Leong Yap and Venu Bhamidipaty
Department of Vascular Surgery, Western Hospital, Gordon Street, Footscray VIC, 3011, Australia
- *Corresponding Author:
- Anastasia Dean
Western Hospital, Gordon Street
Footscray VIC, 3011, Australia
Tel: +61(3)8345 6333
E-mail: [email protected]
Received Date: March 08, 2014; Accepted Date: April 17, 2014; Published Date: April 19, 2014
Citation: Dean A, Yap SL, Bhamidipaty V (2014) Management of Ilio-Femoral Deep Vein Thrombosis: A Hybrid Approach. J Vasc Med Surg 2:131. doi: 10.4172/2329-6925.1000131
Copyright: © 2014 Dean A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Despite recent innovations in clot lysis technology, management of acute ilio-femoral Deep Vein Thrombosis (DVT) remains a challenge worldwide. We revisit the work of a previous generation of vascular surgeons who created a temporary Arteriovenous Fistula (AVF) in combination with a surgical thrombectomy, to maximize blood flow through the newly revascularized vessel. Since this time, surgical thrombectomy along with the use of a temporary AVF, has been superseded by endovascular techniques: namely Catheter-Directed Thrombolysis (CDT) and Pharmacomechanical Thrombolysis (PMCT). We review the evolution of the management of ilio-femoral deep vein thrombosis, specifically examining the trials which investigate temporary AVF with surgical thrombectomy. Furthermore, we describe the surgical technique of creating a temporary AVF, including how to avoid venous hypertension and how to facilitate closure if required. Finally, in the age of hybrid techniques, we propose that a temporary AVF could be used in combination with current thrombus removal techniques to possibly lower the risk of recurrent thrombosis and complications such as post-thrombotic syndrome.