OBJECTIVETo explore the surgical treatment of Cockett's syndrome in patients with deep vein thrombosis of lower extremity (DVT).

METHODSNinety-five patients were diagnosed as Cockett's syndrome among 160 patients with DVT who received surgeries in our hospital from February 1991 to September 2005. Among these 95 patients, pathological changes included left common iliac vein (LCIV) occlusion (n = 20), > 50% stenosis of the LCIV (n = 53), < 50% stenosis (n = 22). All patients received thrombectomy. In patients with LCIV occlusion, resection and reconstruction were performed in 10 patients, iliocaval bypass for 3 patients, and Palma procedures for 3 patients. In patients with > 50% stenosis of LCIV, 5 patients received stent placement, 8 patients received percutaneous transluminal angioplasty (PTA) by dilation balloon catheter, 4 patients received iliac angioplasty, and the other 36 patients received PTA by F8-10 Fogarty thrombectomy catheter. Territorial anticoagulant and lytic therapy were performed through the catheter inserted into the great saphenous vein intraoperatively for 3 days and then venography was performed for all the patients postoperatively. Warfarin was administered for more than 6 months.

RESULTSEighty-two patients (86.3%) were cured. One patient died of myocardial infarction, and the others were improved.

CONCLUSIONSManagement of Cockett's syndrome is essential to increase the cure rate of DVT. Resection and reconstruction is useful for occlusive LCIV, while PTA or stent placement if preferred for severely stenotic vessels.