CURRENT MANAGEMENT OF ILIOFEMORAL DVT Iliofemoral DVT account for up to 25% of all DVTs and are associated with an increased risk of embolic and post-thrombotic complications when compared to more distal DVTs. The iliofemoral segment recanalizes only in about 20% of cases, this causes pelvic venous obstruction, which is associated with more venous claudication and ulceration, and more rapid disease progression. Despite treatment with anticoagulation and compression, up to 50% of patients with iliofemoral DVT will develop Post Thrombotic Syndrome. Early thrombus removal offers a means of restoring venous patency and preserving valve function. These therapies are associated with much faster symptom resolution, return to pre-morbid functional state and less post-thrombotic symptoms. Interventional options for thrombus removal are growing exponentially and are changing our perspective on patient selection since catheter-based approaches offer a safe and effective option that not only benefits patients but also reduces the burden in the healthcare system. In our own experience success rate of over 90% can be achieved with a low complication rate. We present long term outcomes with less than 10% of patients having post-thrombotic syndrome at a median FU of 4 years. We also present the evolution of our treatment protocols, device choice and patient selection.