We have successfully placed catheters in the superficial femoral vein from a contralateral and ipsilateral approach to augment lytic therapy of extensive lower extremity thrombosis. A popliteal approach is not a favored option. Although it is technically feasible, it insults the vein. Despite being a low pressure system, a venous hematoma can occur with continued systemic anticoagulation following catheter removal, especially in an area of joint motion. A hematoma in the popliteal fossa can contribute to rethrombosis due to venous compression.
Nerve injury can result in permanent foot drop.
Therefore, we feel the risk of such consequences is not justified given the availability of femoral and pedal access. If you have any questions regarding a patient or procedure, please do not hesitate to call. We appreciate your questions or comments.