PURPOSE The use of pharmacomechanical thrombectomy in patients with symptomatic iliofemoral deep venous thrombosis (DVT) not responsive to conservative treatment is under-investigated until now. This prompted us to review and analyze our results (technical/clinical outcome, complications) and compare them to the current literature. MATERIALS AND METHODS Between 2013 and 2019, 19 patients (14 women and 5 men; mean age: 41.2 years, SD: 18.2) with iliofemoral DVT and excessive pain not responsive to conservative treatment were treated with pharmacomechanical thrombectomy. Patients were followed up for 12 months. Demographics, technical success and clinical outcome data (pain score/Villalta score) were collected. RESULTS Thrombectomy ± thrombolysis was successful in all cases (n = 19). No major complications were observed. Eight out of nineteen cases developed hematoma at the sheath insertion site not requiring further treatment. Seven out of nineteen cases required additional continuous lysis for complete iliofemoral clot solution. All patients received balloon angioplasty to treat post-thrombotic strictures. In 16/19 cases, stents were placed to preserve iliofemoral caliber and maintain unrestricted iliac venous outflow. Three patients (16%) required re-intervention due to re-thrombosis or in-stent stenosis after 4, 14 days and 4 months, respectively. Symptoms could be improved temporarily or indefinitely in 19 out of 19 patients. 1 year following thrombectomy mean pain score was reduced by 87%, mean Villalta score was 2.6 (SD: 4), and iliofemoral veins were patent in 15/17 patients. CONCLUSION In symptomatic patients with iliofemoral DVT, refractory to conservative treatment, catheter-directed thrombectomy enables rapid and long-lasting pain relief. High patency rates can be achieved in patients receiving PTA and venous stenting post-thrombectomy.

中文翻译：

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对有症状的I股深静脉血栓形成无症状的高度症状患者进行导管定向血栓切除术。

目的迄今为止，对对保守治疗无反应的有症状性of股深静脉血栓形成（DVT）的患者使用药物机械血栓切除术的研究仍不足。这促使我们回顾和分析我们的结果（技术/临床结果，并发症），并将其与当前文献进行比较。材料与方法在2013年至2019年之间，对19例（股DVT和对保守治疗无反应的过度疼痛的患者（14例女性和5例男性；平均年龄：41.2岁，SD：18.2）进行了药物机械血栓切除术治疗。对患者进行了12个月的随访。收集人口统计学，技术成功和临床结果数据（疼痛评分/ Villalta评分）。结果血栓切除术±溶栓术在所有病例中均成功（n = 19）。没有观察到重大并发症。19例中有8例在鞘管插入部位发生血肿，无需进一步治疗。19例中有7例需要额外的连续裂解以完全恢复股of血块。所有患者均接受球囊血管成形术治疗血栓后狭窄。在16/19例中，放置支架以保持股口径并保持不受限制的静脉流出。分别在4、14天和4个月后，有3例患者（16％）因再次血栓形成或支架狭窄而需要再次干预。19名患者中有19名可以暂时或无限地改善症状。血栓切除术后1年，平均疼痛评分降低了87％，平均Villalta评分降低了2.6（标准差：4），股静脉在15/17例患者中获得专利。结论在有症状的with股DVT患者中，保守治疗难以治愈，导管定向血栓切除术能够快速，持久地缓解疼痛。接受PTA和血栓切除术后静脉支架置入的患者可实现高通畅率。