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. 2025 May 15;8(1):43.
doi: 10.1186/s42155-025-00543-0.

Iliofemoral DVT thrombectomy: a dual-access approach to optimise inflow

Robert Wise  1 , Zahi Qamhawi  1 , Emma Wilton  1 , Andrew Wigham  2
Affiliations

Iliofemoral DVT thrombectomy: a dual-access approach to optimise inflow

Robert Wise et al. CVIR Endovasc. .
No abstract available

Keywords: Aspiration thrombectomy; Deep vein thrombosis; Iliofemoral; Inflow.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Consent for publication: Written informed consent was obtained for publication of anonymised data and images for all patients. Competing interests: AW and EW have received consulting and speaking fees from Penumbra Inc.

Figures

Fig. 1
Fig. 1
Computed Tomography imaging showing proximal extent of thrombus in the IVC (white arrow) a, and significant right lower limb superficial oedema (dashed arrow) b
Fig. 2
Fig. 2
Dual-access technique for right lower limb thrombectomy using the right great saphenous vein (GSV) and contralateral left common femoral vein (CFV). A Venography from right GSV demonstrating thrombus in the inferior vena cava (IVC), right common iliac vein (CIV), external iliac vein (EIV), and femoral vein (FV). B Antegrade thromboaspiration of iliac vein and IVC using Lightning Flash (arrowhead). C Up-and-over contralateral sheath with retrograde downstream thrombectomy of inflow vessels using Lightening Flash (dashed arrow) with ipsilateral sheath retracted into GSV (solid arrow). D Final venography demonstrating patency of IVC and right iliac vein. E Patent right femoral vein
Fig. 3
Fig. 3
Computed Tomography imaging showing proximal extent of thrombus in the IVC (white arrow) a, and significant phlegmasia of the expanded left iliac vein (dashed arrow) b
Fig. 4
Fig. 4
Dual-access technique for left lower limb thrombectomy using the left great saphenous vein (GSV) and contralateral right common femoral vein (CFV). A Venography demonstrating inferior vena cava (IVC), left common iliac vein (CIV) and external iliac vein (EIV) thrombosis. IVC and proximal CIV not opacified due to occlusion. Temporary embolic protection from contralateral access (arrowhead). B Iliocaval antegrade thrombectomy using Lightning Flash from GSV access revealing a May- Thurner compression point (dashed arrow) C Stent deployed from GSV access. D Up-and-over retrograde inflow thrombectomy of left profunda femoral vein (PFV), femoral vein (FV) and popliteal vein (not shown) using Lightning Flash (dashed arrow) from contralateral CFV access with GSV sheath retracted. Final venography demonstrating patency of inflow veins
See this image and copyright information in PMC

References

    1. Qamhawi Z, Kearns D, Wilton E, Wigham A. Thrombectomy of the profunda femoral vein in iliofemoral deep venous thrombosis using an antegrade popliteal approach. Cardiovasc Intervent Radiol. 2024;47(3):379–85. - PubMed
    1. Grøtta O, Enden T, Sandbæk G, Gjerdalen GF, Slagsvold CE, Bay D, et al. Infrainguinal inflow assessment and endovenous stent placement in iliofemoral post-thrombotic obstructions. CVIR Endovasc. 2018;1:1–9. - PMC - PubMed
    1. Yu Q, Kwak D, Tran P, Ungchusri E, Wang B, Ahmed SS, et al. Single-session thrombectomy without thrombolysis for iliofemoral deep vein thrombosis: a single-center experience of ClotTriever with evaluation of predictors for reocclusion. Arab J Intervent Radiol. 2024;8(01):19–26.
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