Novosti
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Year 2015 Vol. 23 No 1
GENERAL AND SPECIAL SURGERY
M.G. OREL
THE INCIDENCE OF DETECTION OF LOWER LIMB DEEP VEIN THROMBOSIS IN THROMBOTIC LESIONS OF SUBCUTANEOUS VEINS
Lviv National Medical University named after Danylo Halytsky
Ukraine
Objectives. To detail data of the nature of the vein thrombotic lesions, localization of dilated perforants and their involvement in this pathologic process by ultrasound duplex scanning in patients with the main lower extremity veins thrombosis.
Methods. In the main group the examination of 149 lower limbs in 119 patients (17-82 yrs) with the main vein thrombosis, in the control group – 191 limbs in 121 patients (17-87 yrs) without thrombotic lesions and varicose changes of the lower limb veins have been performed. The ultrasonic device Toshiba Powervision with transducer of exchangeable frequency (5,0-12,0 MHz and 2,5-4,0 MHz) was applied. The different patient’s position, compression and respiratory probes were used.
Results. The main group: the acute and subacute thrombotic lesions of deep and subcutaneous veins were revealed in 121 (81,2%) limbs. The subcutaneous veins thrombosis was found out in 86 limbs (57,7%). Thrombus apex flotation was revealed in 23 (15,4%) limbs. Varicose of the subcutaneous veins was observed in 59,7%. In the main group the dilated perforating veins were found in 61,8%, most often – muscular perforants (32,9%) and Boyd perforants (28,2%). In the control group the dilated perforants were found in 18,9%, the most frequently – Cockett III perforants (7,9%) and Sherman perforants (5,2%). Spreading of thrombotic lesions between the large and small subcutaneous veins pools through the communicating branches has occurred in 2,7% cases. The propagation of thrombosis through dilated perforants to the deep veins was detected in 22,1% cases.
Conclusion. Ultrasonic duplex scanning of the lower limb veins permitted to detail the parameters of thrombotic lesion and the probable ways of its propagation. The authors suggest for the predictive purpose to indicate the status of communicating and perforating branches of the lower limbs veins in the protocol.
- Guillermo Escobar A, Thomas W Wakefield, FACS and Peter K Henke, John T Owings. Venous thromboembolism [Scientific american surgery / Vascular System]. 2011/01 [cited 2014 Nov 04]. Available from: www.sciamsurgery.com/sciamsurgery/institutional/regGetFile.action? fileName=part06_ch06.pdf
- Mishalov VG, Amosova EN, Litvinova IuN, Beichuk SV, Rogovskii V M. Klinicheskie proiavleniia i faktory riska ostrogo tromboza glubokikh ven nizhnikh konechnostei. Effektivnost' i bezopasnost' razlichnykh vidov antikoaguliantnoi terapii (retrospektivnoe issledovanie) [Clinical manifestations and risk factors of acute deep vein thrombosis of the lower extremities. The efficacy and safety of different types of anticoagulation therapy (retrospective study)]. Sertse і Sudini. 2008;(1):33-40.
- Gubka AV, Pertsov VI, Gubka VA. Ostryi tromboz ven nizhnikh konechnostei. Faktory riska, metody profilaktiki i lecheniia [Acute venous thrombosis of the lower extremities. Risk factors, treatment and prevention methods]. Klіn Khіrurgіia. 2003;(3):44-48.
- Baeshko AA. Risk i profilaktika tromboembolicheskikh oslozhnenii v khirurgii [Risk and prevention of thromboembolic complications in surgery]. Khirurgiia 2001;(4):61-69.
- Otraslevoi standart. Protokol vedeniia bol'nykh. Profilaktika tromboembolii legochnoi arterii pri khirurgicheskikh i inykh invazivnykh vmeshatel'stvakh [Industry standard. Treatment protocol. Prevention of pulmonary embolism in surgical and other invasive procedures]. Moscow, RF: N'iudiamed; 2004. 64 p.
- Stoiko IuM, Zamiatin MN. Sovremennye vozmozhnosti profilaktiki tromboembolicheskikh oslozhnenii u patsientov s vysokim i ochen' vysokim riskom [Modern possibilities of prevention of thromboembolic complications in patients with high and very high risk]. Consilium Medicum. Khirurgiia. 2007;(2):40-43.
- Qaseem A, Snow V, Barry P. Management of venous thromboembolism: A clinical practice guideline from the American college of physicians and American academy of family physicians. Ann Intern Med. 2007 Feb 6;146(3):204-10.
- Kharchenko VP, Zubarev AR, Kotliarov PM. Ul'trazvukovaia flebologiia [Ultrasonic phlebology]. Moscow, RF: ZAO Eniki, 2005. 176 p.
- Churikov DA, Kirienko AM. Ul'trazvukovaia diagnostika boleznei ven [Ultrasound diagnosis of vein diseases]. Moscow, RF: Littera; 2006. 96 p.
- Mostovii IuM. Tromboembolіia legenevoї arterії: suchasnі standarti dіagnostiki ta lіkuvannia (metodichnі rekomendatsії) [Pulmonary artery: current standards for diagnosis and treatment]. Vіnnitsia, Ukraine; 2003. 55 p.
- Rusin VІ, Levchak IuA, Boldіzhar PO. Suchasna dіagnostika gostrikh venoznikh trombozіv. Aktual'nі problemi suchasnoї meditsini [Current diagnosis of acute venous thrombosis. Actual problems of modern medicine]. Ukr Med Stomat Akad. 2007; 7(2):277-81.
- Prevention and treatment of venous thromboembolism. International Consensus Statement // Int Angiol [Electronic Resource]. 2013;32(2):111–60. available from:
http://www.europeanvenousforum.org/files/publications/guid_vte/IUA_Guidelines_2013. - Savel'ev VS, Gologorskii VA, Kirienko AI./ red Savel'ev VS. Flebologiia: Rukovodstvo dlia vrachei [Phlebology: a guide for physicians]. Moscow, RF: Meditsina; 2001. 664 p.
- Chernukha LM, Nikul'nikov PI, Guch AA, Artemenko MO. Venoznyi tromboz nizhnikh konechnostei. Vozmozhno li reshenie problemy segodnia? [Venous thrombosis of the lower extremities. Is it possible to solve the problem today?] Klіn Khіrurgіia. 2007;(10):48-54.
- Rusin VІ, Korsak VV, Boldіzhar PO, Madі Iu Iu. Poєdnannia gostrogo varіkotromboflebіtu maloї pіdshkіrnoї veni z trombozom litkovikh ven [The combination of acute varicothrombophlebitis of small saphenous vein thrombosis of the calf veins]. Nauk Vіsn Uzhgorod un-tu, Ser Meditsina, 2012;2(44):97-100.
- Nabil Aly. Superficial thrombophlebitis or deep vein thrombosis? GM: Midlife & Beyond. 2010;(40)12:699-704.
79010 Ukraina,
g. Lvov, ul. Pekarskaya, d. 69,
Lvovskiy natsionalnyiy meditsinskiy universitet im. Danila Galitskogo,
kafedra operativnoy hirurgii s topograficheskoy anatomiey,
tel. office: 38 (032) 275-59-31,
e-mail: orelmasha@ukr.net,
Orel Mariya Glebovna
Orel M.G. An assistant of the operative surgery with topographic anatomy chair of Lviv National Medical University named after Danylo Halytsky.