[Thrombectomy with AV fistula in embolizing deep venous thrombosis--better therapeutic concepts]

Abstract

From 1977 to March 1986 69 patients with embolizing deep vein thrombosis underwent thrombectomy plus av-fistula. The perioperative mortality rate was 7.2%, the rate of recurrent pulmonary embolism during follow up (28 +/- 24 months) 4.7% - all minor non-significant emboly-including those with an embolizing thrombosis of the contralateral deep venous system. In 62% preservation of valve competence was successful. As intracaval filter devices for prevention of recurrent pulmonary embolism have many severe complications, out of which the embolisation by the filter itself seems to be the most problematic, the first step of surgical management must be the removal of the embolizing source--thrombectomy plus routine av-fistula.