Year 2015 Vol. 23 No 3




National Institute of Surgery and Transplantology of AMS Ukraine Named after O.O. Shalimov1
Vinnitsa Regional Hospital Named after N.I. Pirogov2
Vinnitsa National Medical University Named after N.I. Pirogov3

Objectives. To develop differentiated surgical tactics in treatment of patients with deep venous thrombosis (DVT) complicated by pulmonary embolism (PE).
Methods. The treatment results of 58 patients with DVT complicated by PE had been analyzed. There were 9 (15,5%) patients with higher early risk of death according to the classification of European Society of Cardiology (ESC), 14(24%) – with intermediate risk and 35 (60,5%) – with a low risk. In 55 cases (94%) a majority of pulmonary embolism are caused by DVT, and in 3 cases (6%) the cause of pulmonary embolism could not be found. DVT of the proximal localization was observed in 46 (79%) cases. Systemic thrombolysis of DVT complicated by PE was carried out in the group of patients with higher and intermediate early risk of death in 16 (69,5%) cases. Catheter-guided thrombolysis was conducted at ileo-femoral DVT complicated by PE in the group of patients with low risk of early death and in terms up to 7 days in 10 (28,5%) cases.
Results. Significant improvement for patients who received thrombolytic therapy was identified in 21 (82%) cases. Partial improvement in the patients who used anticoagulant therapy was registered in 17 (67%) cases. It manifested in the reduction of dyspnea, tachypnea, chest pain, and cough. According to the CT data the total desobstruction of the pulmonary tree was found in 3 (5%) cases. No hemorrhagic complications were observed and no fatal outcomes were reported. Within the study period, recurrent pulmonary embolism has not been ascertained.
Conclusion. Systemic thrombolysis of DVT complicated by pulmonary embolism is indicated in the group of patients with higher and intermediate risk of early death. Catheter-guided thrombolysis is indicated for ileo-femoral DVT, complicated by PE, in patients with low early risk of death and in terms up to 7 days.

Keywords: deep veins thrombosis, pulmonary embolism, classification of European Society of Cardiology, thrombolytic therapy, systemic thrombolysis, catheter-guided thrombolysis
p. 309-313 of the original issue
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Address for correspondence:
21000, Ukraina,
g. Vinnitsa, ul. Pirogova, d. 46,
otdelenie khirurgii sosudov
Vinnitskaya oblastnaya klinicheskaya
bolnitsa im. N.I. Pirogova,
otdelenie khirurgii sosudov,
tel. mob.: 380969917476,
Khrebtiy Yaroslav Vitalevich
Information about the authors:
Chernuha L.M. MD, a leading researcher of the department of the vascular surgery of the National Institute of Surgery and Transplantology of AMS of Ukraine named after A.A. Shalimov.
Skupii O.M. MD, a head of the vascular surgery unit of Vinnitsa Regional Clinical Hospital named after N.I. Pirogov.
Mitiuk A.I. PhD, an associate professor of the surgery chair №2 of Vinnitsa National Medical University named after N.I. Pirogov.
Khrebtiy Y.V. PhD, an assistant of the surgery chair №2 of Vinnitsa National Medical University named after N.I. Pirogov.
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