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Forty-three consecutive patients with greater saphenousvein (GSV) thrombosis extending
to the saphenofemoral junction (SFJ) were treated. Twenty-three patients had extension
of thrombus into the common femoral vein (CFV). Twenty patients had thrombus extending
to but not within the CFV. Symptoms, risk factors, and physical examination were not
predictive of CFV thrombus extension. When compared with the operative record, duplex
scans accurately located the extent of the thrombosis 100% of the time. Forty-one
surgical procedures were performed. No patients had pulmonary emboli during the procedures.
Thirty-seven patients were treated as outpatients or were discharged within 3 days
of their surgical procedures. The two patients who did not undergo operative procedures
in this series had complete occlusion of the CFV with extension into the external
iliac vein. Thrombus within 3 cm of the SFJ is an indication for surgical intervention.
Disconnection of the GSV from the CFV prevents extension of the thrombus, and a limited
CFV thrombectomy can be performed when necessary. This is considerably more cost-effective
than treatment with anticoagulation.
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Article info
Footnotes
**Presented at the 20th Annual Meeting of the Society for ClinicalVascular Surgery, Orlando, Florida, March 25–29, 1992.
Identification
Copyright
© 1992 Reed Publishing USA. Published by Elsevier Inc.
