RESUMO
BACKGROUND: The aim of this paper was to evaluate the effectiveness and long-term outcome of combined catheter-directed thrombolysis (CDT) and iliac vein recanalization in management of iliac vein compression syndrome (IVCS) with secondary acute deep vein thrombosis (DVT). METHODS: From January 2006 to February 2014, consecutive patients with IVCS and secondary acute DVT were treated with combined CDT and iliac vein recanalization. Data on technical success, clinical success, and follow-up were analyzed respectively. RESULTS: A total of 55 patients were included in this retrospective study. Technical success was achieved in all patients. The filter was placed in 24 patients and all filters were successfully retrieved after treatment. The total dose of urokinase ranged from 1.6×106 to 6.6×106 units (mean, 3.72±0.13×106 units). The thrombus were totally dissolved in all patients. The iliac venous stents were placed in 7 patients. Clinical success was achieved in all patients. During the follow-up of 6-103 months (mean, 35.87±27.86 months), eight patients experienced the recurrence of DVT 1-39 months (mean, 13.13±12.25 months) after treatment. The cumulative 1-, 3-, and 6-year primary patency rates were 88.5, 85.3 and 80.0%, respectively. The cumulative 1-, 3-, and 6-year secondary patency rates were 98.0, 94.2, and 88.7%, respectively. At univariate and multivariate analysis, the independent predictor of recurrence of DVT was INR<2 after treatment. CONCLUSION: Combined CDT and iliac vein recanalization could provide a favorable effectiveness and long-term outcome for patients with IVCS and secondary acute DVT.