Charles Rob, Alfred Nobel and Aphrodite: the development of surgery for venous thromboembolism.

Charles Rob and the vascular surgeons at Strong Memorial Hospital have made significant contributions to the development of venology. Their impact on the surgical treatment of venous thromboembolism is emphasized. The technique for thrombectomy with temporary arteriovenous fistula is described. In a prospective randomized study from Sweden iliac vein patency was found in 76% of the operated group and 35% of the conservatively treated group after 6 months, and 77% versus 30%, respectively, after 5 years. A patent femoropopliteal vein with competent valves was found in 52% of the surgically treated patients compared with 26% of those treated conservatively after 6 months, and 36% versus 11%, respectively, after 5 years. Thrombectomy with temporary arteriovenous fistula is the author's method of choice to treat patients with acute iliofemoral venous thrombosis if the history of swelling of the thigh indicating iliac vein obstruction is less than 7 days' duration and the activity expectancy of the patient is more than 10 years.