Background: Postthrombotic syndrome (PTS) can develop in nearly 50 % of all patients who experience an iliofemoral and caval thrombosis which has a significant negative effect on the patients' quality of life.
Results: Treatment options for PTS include conservative treatment, open surgical treatment and endovascular treatment of obstruction/occlusion. The open surgical procedures are limited to studies with a low number of cases and have a patency rate of 58-100 %. The complications of these invasive methods are thrombotic occlusion of graft, hematomas and wound healing disorders.
A patency rate of 73-100 % can be achieved with the endovascular treatment. Studies with larger case numbers are available for this procedure. Thrombotic stent occlusion and hematomas can be mentioned as its complications. Unlike conservative therapies, there are no randomized studies on surgical treatment methods. As the result, only a weak recommendation level (II b) for the operative procedures has been suggested.
Conclusion: In a case of chronic venous obstruction (CVO), all conservative treatment options should first be exhausted. With furthermore existing complaints in the sense of PTS with a restriction of the quality of life, an invasive therapy procedure should be considered. In this case, the endovascular recanalization is the first choice of treatment. Randomized studies are necessary to achieve a better degree of recommendation.
- vein reconstruction
- COMMON FEMORAL VEIN
- INFERIOR VENA-CAVA
- POSTTHROMBOTIC SYNDROME
- VENOUS THROMBOSIS
- ENDOVASCULAR MANAGEMENT
- OBSTRUCTIVE LESIONS