Objective:To explore the effect of combined treatment of critical deep vein thrombosis of the lower extremity with inferior vena cava filter placement and thrombectomy,treatment of Cockett syndrome and use of anticoagulation and thrombolysis after thrombectomy.
Methods:We reviewed the clinical data of 9 patients with critical deep vein thrombosis of the lower extremity treated between 1996 to 2009. Eight patients were treated with inferior vena cava filter placement, thrombectomy,treatment of Cockett syndrome, and anticoagulation and thrombolysis after thrombectomy. Seven patients with critical deep vein thrombosis of the left lower extremity were found to have Cockett syndrome(2 patients were treated).One patient with critical deep vein thrombosis of the left lower extremity was treated with thrombolysis.
Results:There were no cases of pulmonary embolism in  these patients.Of the 8 patients with thrombectomy,1 patient with critical deep vein thrombosis of the left lower extremity developed gangrene of lower extremity and underwent amputation of the limb.The other lower extremities of 7 patients were salvaged, and the results were satisfactory. One patient died who was treated with thrombolysis.At 1 month after operation, color doppler ultrasound was performed on 5 patient whose Cockett syndrom was not treated, and showed that 2 patients had recurrence of deep vein thrombosis,but none of the 2 patients had recurrence of phlegmasia cerulea dolens.
Conclusions:The combined treatment of critical deep vein thrombosis of the lower extremity with inferior vena cava filter placement, thrombectomy, treatment of Cockett syndrome and anticoagulation,and  thrombolysis after thrombectomy is effective.Cockett syndrome is an important cause for the relapse of deep vein thrombosis of the lower extremity after thrombectomy.