ABSTRACT

We aimed to describe the long-term outcome of endovascular treatment of iliofemoral deep vein thrombosis in the postpartum period.

Between 2002 and 2010, 18 consecutive female patients with acute or subacute iliofemoral deep vein thrombosis in the postpartum period who had endovascular treatment were retrospectively evaluated. Treatment consisted of manual aspiration thrombectomy with or without catheter-directed thrombolysis. Stents were placed in the iliac veins, if deemed necessary. Clot removal was graded as complete (>95%), partial (50%–95%), and poor (<50%).

The initial treatment was technically successful in 17 patients (94%). There was complete clot removal in 15 of 22 limbs (68%). Twenty-three stents were implanted in 15 patients (83%). The primary and secondary patencies were 58% and 82% at one year, 58% and 72% at three years, and 58% and 58% at ¡ve years, respectively. There were recurrent thromboses in 11 patients (61%), which occurred within the ¡rst month in nine of these patients (81%). Ten patients had repeated intervention, and ¡ve had successful outcomes. At a mean follow-up of 30 months, 11 patients had uninterrupted in-line ¢ow in the affected lim b, and six patients did not. Six of the patients with uninterrupted ¢ow were asymptomatic, and ¡ve patients had minimal swelling at the ankle.

Endovascular treatment of postpartum iliofemoral deep vein thrombosis with percutaneous aspiration thrombectomy alone or combined with catheter-directed thrombolysis and iliac vein stenting is an effective therapy resulting in a high rate of thrombus removal. However, recurrences are high, particularly in the ¡rst post-intervention month. Frequent patient followup in the ¡rst post-intervention month is necessary.

Keywords: thrombectomy • mechanical thrombolysis • May-Thurnersyndrome