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Khirurgii

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Year 2015 Vol. 23 No 5

GENERAL & SPECIAL SURGERY

V.J. KHRYSHCHANOVICH1,2, I.P. KLIMCHUK1, A.V. EMELYANENKO2, S.S. KALININ1,2

THE RESULTS OF TREATMENT OF PATIENTS WITH INFERIOR VENA CAVA THROMBOSIS

EE "Belarusian State Medical University"1, EH "The 4th City Clinical Hospital named after Savchenko"2,
Minsk
The Republic of Belarus

Objectives. To determine the most common causes, frequency of thromboembolic complications (TEC), results of diagnostics and treatment of patients with inferior vena cava thrombosis (IVC).
Methods. A retrospective study in resident patients (n=22) with the inferior vena cava thrombosis has been carried out. The average age of twenty two patients was 53 ± 2 years. In cases of suspicion for a deep vein thrombosis (DVT) in the IVC system, its causes, character, localization, prevalence and complications were determined by ultrasonography and phlebocavagraphy. IVC thrombosis management included anticoagulants, elastic compression, and phlebotonics. Four (18.2%) patients with embolo-dangerous thrombosis had undergone surgical procedures – inferior vena cava thrombectomy with its implication (2 cases), isolated IVC plication, cava-filter implantation.
Results. The reason of the IVC thrombosis in 21 of 22 patients was an upward iliofemoral DVT on the background of cancer pathology (35%), chronic inflammatory diseases (10%) after surgery and childbirth (10%). In two (10%) cases, there was a DVT of the lower extremities in anamnesis. In six (30%) cases the cause of IVC thrombosis has not been established. Infrarenal, renal and suprarenal IVC thrombosis were diagnosed in 19 (86%), 2 (9%) and 1 (5%) patients, respectively. Thrombus flotation with a head length of 2-8 cm in IVC was identified in 4 cases. TEC occurred in three (13,6%) patients. Such complication as cava-filter thrombosis occurred in one case.
Conclusion. In all patients with proximal DVT of the lower extremities IVC involvement in the thrombotic process should be suspected. Early diagnosis and proper treatment of IVC thrombosis is considerd to be guarantee of a favorable outcome of the disease and to prevent complications. It’s necessary to continue an examination of compression hosiery and phlebotonics in rehabilitation of patients undergoing IVC thrombosis.

Keywords: aetiology, diagnosis, inferior vena cava, prognosis, thrombosis, compression hosiery, complications, treatment
p. 525-532 of the original issue
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Address for correspondence:
210024, Respublika Belarus',
g. Minsk, ul. Kizhevatova, d. 58,
UZ "Gorodskaia klinicheskaia bol'nitsa skoroi meditsinskoi pomoshchi",
2-ia kafedra khirurgicheskikh boleznei,
UO "Belorusskii gosudarstvennyi meditsinskii universitet".
tel. mob.:+375 29 624 55 78,
e-mail: vladimirkh77@mail.ru,
Khryshchanovich Vladimir Ianovich
Information about the authors:
Khryshchanovich V.J. MD, an associate professor of the 2nd chair of surgical diseases of EE "Belarusian State Medical University ", Minsk.
Klimchuk I.P., PhD, a head of vascular and phlebological surgery department of "The 4th CCH named after N.E. Savchenko”, Minsk
Emelianenko A.V., a physician-intern of department of vascular and phlebological surgery EH "The 4th CCH named after N.E. Savchenko", Minsk.
Kalinin S.S., an angiosurgeon of Department of Vascular and phlebological surgery EH "The 4th CCH named after N.E. Savchenko", Minsk.
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