Presentation

Recanalization techniques of chronic iliofemoral vein occlusions

This video resumes the steps of performing a recanalization and stenting of a post-thrombotic iliofemoral vein oclussion including phlebographic and IVUS assessment.

Key words: Venous stenting, venous recanalization, posthrombotic syndrome, iliofemoral occlusion, deep vein thombosis, IVUS

Comments

    MD Martin Schroeder
    August 16, 2018

    Thank you for this excellent step by step case presentation.
    What is your follow up regime in this case and what anticoagulation- for how long do you recommend? Thank you.

    This is a young woman who suffered a postpartum iliofemoral DVT and a failed lytic therapy attempt in another center. The cause was probably an underlying May-Thurner compression with a negative thrombophilia workup. As there were more than two venous segments affected we kept him in oral anticoagulation for 12 months and after long life aspirin
    In my practice I use these regimes:
    – NIVL:
    Bemiparine 3500 UI / SC at 6 and 24 hours after the procedure followed by aspirin 100 mg PO / 24 hours for 12 months.

    – CHRONIC DVT:
    Lesions involving ≤ 2 venous segments: Bemiparine 3500 UI / SC at 6 and 24 hours after the procedure followed by aspirin 100 mg PO a day for 12 months.

    Lesions involving ≥ 3 segments, thrombophilia, previous anticoagulant treatment and poor venous inflow: Bemiparin at weight-adjusted therapeutic dose / 24 hours SC for 15 days followed by oral anticoagulation for at least 12 months.

    – ACUTE DVT: Bemiparin at weight-adjusted therapeutic dose / 24 hours SC for 15 days followed by oral anticoagulation for at least 12 months.

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