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Feature Article

Iliofemoral venous thrombosis: developments in management

David Robinson

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Abstract

Iliofemoral deep venous thrombosis (DVT) poses a higher risk of ongoing problems than more distal DVT. In selected patients, early treatment with thrombus removal as well as anticoagulants may significantly reduce the incidence of post-thrombotic syndrome. In patients with chronic iliofemoral obstruction, newer endovascular approaches offer promising results.

Key Points

  • Patients with iliofemoral deep venous thrombosis (DVT) may have a more severe spectrum of presentations than those with more distal DVT.
  • Post-thrombotic syndrome is more common after iliofemoral DVT than after more distal DVT.
  • Early intervention to remove an iliofemoral thrombus and correct underlying anatomical abnormalities, as well as anticoagulation, may help improve long-term outcomes.
  • Options for thrombus removal include catheter-directed thrombolysis and pharmacomechanical or surgical thrombectomy.
  • In patients with chronic venous problems after iliofemoral DVT, newer endovascular interventions may improve symptoms.

    Picture credit: © John Karapelou.

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