ABSTRACT
The main reason to adopt a strategy of thrombus removal is the severe morbidity associated with post-thrombotic syndrome resulting from lower extremity deep vein thrombosis (DVT), especially iliofemoral DVT. Although operative venous thrombectomy is infrequently required because of the increased safety and effectiveness of catheter-directed thrombolysis (CDT) for iliofemoral DVT, it remains a valuable treatment option in selected patients. The proximal and distal extent of the DVT should be clearly defined with venous duplex, computed tomography venography, magnetic resonance venography, or contralateral iliocavography. Anticoagulation alone in the management of iliofemoral DVT has high morbidity, with up to 40% of patients complaining of venous claudication. General anesthesia is usually recommended for patients undergoing operative venous thrombectomy. A longitudinal inguinal incision under ultrasound (US) guidance exposes the common femoral vein (CFV), femoral vein, saphenofemoral junction, and profunda femoris vein (PFV).
