Thrombectomy is indicated when viability of the limb is threatened, as in phlegmasia cerulea dolens, particularly in situations where thrombolysis is contraindicated.
Surgery has also been recommended for iliofemoral thrombosis when it is felt that there is a particularly high risk of pulmonary embolism.
Thrombectomy is considered when the thrombus is non-adherent and less than 3 days old. It should always be followed by anticoagulation for 3-6 months.
The procedure is associated with further risk of thrombosis, haemorrhage and pulmonary embolism.
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