Abstract: Objective To evaluate the surgical techniques for acute left deep venous thrombosis (LDVT) secondary to left iliac
vein compression syndrome (IVCS). Methods Thirty-six patients with acute LDVT secondary to IVCS received inferior vena
cava filter placement, and in 2 of the cases, stent implantation was canceled for acute episode of obsolete DVT. The remaining
34 patients underwent left femoral venotomy for iliofemoral thrombectomy with Fogarty catheter and distal femoral vein
thrombus removal by sequential compression of the legs, followed by implantation of stent-graft (2 cases) or bare-metal stents
(32 cases) in the left common iliac veins. With routine anticoagulation and thrombolytic treatments, the patients were regularly
examined for postoperative blood flow in the affected limb. Results In 2 of the cases undergoing bare-metal stent implantation,
the residue thrombi were squeezed into the stent by balloon, which was managed subsequently with local thrombolysis. One
patient with bare-metal stent implantation received a secondary stenting for posterior stent displacement. Three patients had
self-limited bleeding due to decreased serum FBG. Significant improvements were achieved at 3, 6, 30 and 180 days
postoperatively in the circumferences of the affected limb (P<0.05) and in the levels of D-dimer (P=0.011), and FBG level
showed no significant variations (F=1.163, P=0.345). The total rate of excellent outcomes was 83.3% (26/34) with a total effective
rate of 91.2% (31/34) in these cases. Conclusions Thrombectomy to revascularize the inflow tract and stent implantation to
enlarge stenosed iliac veins are key issues in treatment of acute LDVT secondary to IVCS.