Novosti
Khirurgii

 This journal is
indexed in Scopus
journal cover
android icon Android Applicaion

Year 2013 Vol. 21 No 4

EXCHANGE OF EXPERIENCE

V.I. RUSYN1, Y.M. POPOVYCH1, V.V. KORSAK1, P.O. BOLDIZHAR1, YU.S. NEBYLITSIN2

SURGICAL PREVENTION OF PULMONARY EMBOLISM AT THE DEEP VENOUS THROMBOSIS OF TIBIOPOPLITEAL SEGMENT

SHEE “Uzhgorod National University” 1
The Ukraine
EE “Vitebsk State Medical University” 2,
The Republic of Belarus

Objectives. To evaluate short- and long-term results of the operative treatment at the deep venous thrombosis of the femoral-popliteal segment.
Methods. The analysis of the examination results of 25 patients with the deep venous thrombosis located in the femoral-popliteal segment and the presence of floating thrombus in the general and superficial femoral veins has been carried out in the paper. The complex of clinical and instrumental examination of patients included duplex ultrasonography, Doppler, radiopaque venography and radioisotope phleboscintigraphy. It allowed evaluating the functional status of the collateral blood flow and justifying the indications for surgical treatment of deep venous thrombosis of the lower extremities. The volume of the operative treatment included the open thrombectomy in the femoral veins, followed by the ligation of the superficial femoral veins below the confluence of the deep vein of the thigh. In the distant period the quantitative evaluation of the surgical treatment results was performed according to the current guidelines on the evaluation of patients with chronic venous disease of the lower limbs (VCSS clinical scale and the scale of work-capacity reduction VDS).
Results. The results have showed the high efficiency and appropriateness of surgical treatment – thrombectomy of the femoral-popliteal segment with the ligation of the superficial femoral vein. The given type of surgery in patients with thrombosis of the femoral -popliteal segment permitted to reduce the clinical manifestations of post-thrombotic syndrome and chronic venous insufficiency in the postoperative period.
Conclusions. Early thrombectomy is considered as an effective and pathogenetically justified method of surgical treatment. The widespread application of the open surgical treatment of deep venous thrombosis of the lower extremities allows preventing the pulmonary embolism and minimizing the effects of chronic venous insufficiency.

Keywords: deep venous thrombosis, thrombectomy, prevention of pulmonary embolism, post-trombophlebitic syndrome, radioisotope phleboscintigraphy
p. 118 - 123 of the original issue
References
  1. Savchenko V.I. Venoznye trombozy [Venous thrombosis]. Prakt Angiologiia [Elektronnyi resurs]. 2009 iiul';(5/6). Rezhim dostupa: http://angiology.com.ua.
  2. Rusin V², Levchak IuA, Bold³zhar PO. Vidi kh³rurg³chnikh vtruchan' pri flotuiuchikh trombakh sistemi p³dkol³nno¿ veni [Types of surgery in floating thrombus of the popliteal vein]. Khark³v Kh³rurg Shk. 2009;(2.2):185–87.
  3. Savel'ev VS, Gologorskii VA, Kirienko AI, i dr. Savel'ev VS, red. Flebologiia [Phlebology]: ruk dlia vrachei. Moscow, RF: Meditsina; 2001. 664 p.
  4. Haferkamp A, Kurosch M, Pritsch M, Hatiboglu G, Macher-Goeppinger S, Pfitzenmaier J, Pahernik S, Wagener N, Hohenfellner M. Prognostic factors influencing long-term survival of patients undergoing nephron-sparing surgery for nonmetastatic renal-cell carcinoma (RCC) with imperative indications. Ann Surg Oncol. 2010 Feb;17(2):544–51.
  5. Jacobs DG, Sing RF. The role of vena caval filters in the management of venous thromboembolism. Am Surg. 2003 Aug;69(8):635–42.
  6. Zhukov BN, Kostiaeva EV, Kostiaev VE, Katorkin SE. Problemy reabilitatsii i vosstanovitel'noi terapii bol'nykh, perenesshikh tromboz glubokikh ven nizhnikh konechnostei [Problems of rehabilitation and restorative therapy in patients with lower extremity deep vein thrombosis]. Vestn Vosstanov Meditsiny. 2009;(4):54–59.
  7. Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ; American College of Chest Physicians. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008 Jun;133(6 Suppl):454S–545S.
  8. Enden T, Klîw NE, Sandvik L, Slagsvold CE, Ghanima W, Hafsahl G, Holme PA, Holmen LO, Njaastad AM, Sandbaek G, Sandset PM. Catheter-directed thrombolysis vs. anticoagulant therapy alone in deep vein thrombosis: results of an open randomized, controlled trial reporting on short-term patency. J Thromb Haemost. 2009 Aug;7(8):1268–75.
  9. Grewal NK, Martinez JT, Andrews L, Comerota AJ. Quantity of clot lysed after catheter-directed thrombolysis for iliofemoral deep venous thrombosis correlates with postthrombotic morbidity. J Vasc Surg. 2010 May;51(5):1209–14.
  10. Hilleman DE, Razavi MK. Clinical and economic evaluation of the Trellis-8 infusion catheter for deep vein thrombosis. J Vasc Interv Radiol. 2008 Mar;19(3):377–83.
  11. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008 Jun;133(6 Suppl):381S–453S.
  12. Miyamoto T, Niwa A. The inferior vena caval filter to prevent from an onset or a recurrence of acute pulmonary thromboembolism. Nihon Rinsho. 2003 Oct;61(10):1775–79.
  13. Baeshko AA. Posleoperatsionnyi tromboz glubokikh ven nizhnikh konechnostei i tromboemboliia legochnoi arterii [Postoperative lower extremity deep vein thrombosis and pulmonary embolism]. Moscow, RF: Triada-Kh; 2000. 136 p.
  14. Dubrovskii AV, Karalkin AV, Al'bitskii AV, Saitova GD, Dzhenina OV. Funktsional'naia anatomiia venoznogo rusla nizhnikh konechnostei i obosnovanie khirurgicheskogo vmeshatel'stva pri ostrykh flebotrombozakh [Functional anatomy of the venous system of the lower limbs and the justification of surgery in acute phlebothrombosis]. Grudnaia i Serdech-Sosud Khirurgiia. 2004;(4):34–39.
Address for correspondence:
88010, Ukraina, g. Uzhgorod, ul. Kapushanskaia, d. 22, GVUZ «Uzhgorodskii natsional'nyi universitet», Zakarpatskaia oblastnaia klinicheskaia bol'nitsa im. A. Novaka, kafedra khirurgicheskikh boleznei,
e-mail: angiosurgery@i.ua,
Popovich Iaroslav Mikhailovich
Information about the authors:
Rusin V.I. MD, professor, a head of the surgical diseases chair of SHEE “Uzhgorod National University”.
Popovich Y.M. PhD, An assistant of the surgical diseases chair of SHEE “Uzhgorod National University”.
Korsak V.V. MD, professor of the surgical diseases chair of SHEE “Uzhgorod National University”.
Boldizhar P.O. MD, professor of the surgical diseases chair of SHEE “Uzhgorod National University”.
Nebylitsin Yu.S. PhD, an associate professor of the chair of general surgery of EE “Vitebsk State Medical University”.
Contacts | ©Vitebsk State Medical University, 2007-2023