A series of 408 patients with acute thrombosis in the iliofemoral area was operated on over the last fourteen years. The operative indication and prognosis depend on localizing the origin and duration of the thrombus. We differentiate among three type of thrombosis: iliofemoral, sapheno-femoro-iliac, and femo roiliac.
The duration of the thrombi varied from three to thirty days. In the first and second type, there is a great danger of pulmonary embolism. In such cases, operative treatment is indicated. In the third type of thrombosis, the confluent point is ascendingly obliterated. There is little danger of pulmonary embolism, for the peripheral pressure is not raised. Intraoperative prophylaxis for embo lism by means of a balloon catheter placed contralaterally is not necessary. Of this group, 284 patients were followed up over a period of one to fourteen years. Good results were seen following thrombectomy of type I and II throm bosis. The third type of thrombosis showed worse results.
In type I and II thrombosis, fibrinolysis can easily cause pulmonary embo lism, for the peripheral venous pressure is high, but in thrombosis of the third type, the danger of pulmonary embolism is relatively small. The results of fi brinolysis in this ascending type are better than the results of surgery.
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