Background and Aims: Acute iliofemoral deep venous thrombosis can lead to serious complications. The techniques such as catheter-directed thrombolysis (CDT), percutaneous mechanical thrombectomy (PMT) and manual aspiration thrombectomy (MAT) are currently available treatment methods. The aim of this study was to compare the efficacy and safety of MAT versus PMT followed by stent placement in treatment of patients with iliofemoral deep venous thrombosis caused by iliac vein occlusion, so as to provide the reference for clinical treatment options. 
Methods: The clinical data of 63 patients undergoing treatment in the vascular surgery department for iliofemoral deep venous thrombosis caused by iliac vein occlusion were retrospectively analyzed. Among these patients, 28 cases received MAT (MAT group) and 35 cases underwent PMT with AngioJet system (PMT group). Patients in both groups underwent simultaneous stent implantation of the iliac vein after thrombectomy. 
Results: The clinical technical success rates were 100% for both groups. There were no significant differences between the two groups in terms of rate of grade III thrombus clearance, degree of detumescence at 24 h. proportion of cases requiring postoperative CDT, length of hospital stay and length of the stent used (all P>0.05). In MAT group, the operative time was shorter, but the gamma exposure time was longer than those in PMT group, the intraoperative blood loss was less, but the dose of urokinase used was greater than those in PMT group, and the total hospital cost was less than that in PMT group, and all differences had statistical significance (all P<0.05). No severe complications and adverse reactions in both groups. Postoperative follow-up was conducted for 12 to 24 months, and stent patency rate and the Villalta scores showed no significant differences between the two groups (both P>0.05).   
Conclusion: Acute thrombus removal using MAT or AngioJet PMT with simultaneous stent implantation of the iliac vein has the same efficacy and safety in the treatment of IFDVT. However, by comparison, MAT has the advantages of requiring no specific equipment, less costs and easy operation as well as reduced use of thrombolytic drug. So, It is a recommendable treatment method.