Greenfield LJ, Alexander EL.
Current status of surgical therapy for deep vein thrombosis.
Am J Surg 1985 Oct 8;150(4A):64-70

There is renewed interest in the use of operative thrombectomy in the management
of acute DVT using the adjuncts of heparin infusion through an indwelling
catheter and pneumatic segmental compression of the leg. In the absence of
phlegmasia cerulea dolens, however, the indication for thrombectomy remains
unresolved. For the postthrombotic syndrome, the most widely accepted procedure
is the Palma femorofemoral cross-over bypass, which is indicated for relief of
persistent unilateral iliac venous obstruction. Venous valvular incompetence is a
much more challenging problem for which some limited success has been achieved by
direct valvuloplasty, venous transposition, and autologous vein valve
transplantation. For the most serious complication of venous thrombosis,
pulmonary embolism, the evolution of mechanical devices has eliminated the need
for direct approaches to the vena cava, and the long-term results with the
Greenfield filter allow it to be placed in either an infrarenal or suprarenal
position with assurance of long-term patency.