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To evaluate the clinical safety and effectiveness of percutaneous mechanical thrombectomy in patients with acute massive lower extremity deep venous thrombosis.Twenty-five consecutive patients with acute massive lower extremity deep venous thrombosis were included in this retrospective study. An inferior vena cava filter was placed prophylactically to protect against pulmonary embolism in each patient. Percutaneous mechanical thrombectomy was performed using a 7F Amplatz thrombectomy device in an angiography suite through ipsilateral popliteal vein access. Anticoagulant therapy lasted for at least 6 months. Follow-up data included 1 year's color duplex sonography and clinical interviews.Successful placement of an inferior vena cava filter was achieved in all 25 (100%) patients. Twenty-two patients (88%) were clinically asymptomatic within 24 hours, whereas the remaining 3 patients (12%) showed moderate improvement within 48 hours. Venogram at discharge showed grade III lysis in 23 patients (92%) and grade II lysis in 2 patients (8%). No serious complications were reported during hospitalization in this study. At 1-year follow-up, no recurrent deep venous thrombosis was reported; 1 patient developed a mild postthrombotic syndrome.Percutaneous mechanical thrombectomy is a safe and effective treatment for acute massive lower extremity deep venous thrombosis and shows promising clinical mid-term results.