Early and Remote Results of Surgical Treatment of Inferior Vena Cava Thrombosis
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Keywords


deep vein thrombosis
inferior vena cava
thrombectomy
conservative treatment
postoperative period

Abstract

The objective of the research was to estimate the early and remote results of surgical treatment in patients with deep vein thrombosis of the inferior vena cava.Material and methods. The results of treating 790 patients with lower limb deep vein thrombosis and thrombosis of the inferior vena cava were analyzed. Depending on treatment, all the patients were divided into the following groups: Group IA consisted of 380 (68.5%) patients with deep vein thrombosis who underwent open complete or partial thrombectomy with or without surgical prevention of pulmonary thromboembolism; Group IB consisted of 50 (9.0%) patients with deep vein thrombosis who received combined treatment with surgical prevention of pulmonary thromboembolism; Group IC consisted of 125 (22.5%) patients with transfascial thrombosis who underwent thrombectomy of the apical thrombotic masses of deep veins followed by radical venectomy; Group II consisted of 235 (29.7%) patients with deep vein thrombosis who received conservative anticoagulant therapy only.For investigation of patients, there were used the following laboratory methods of examination: duplex ultrasound scanning, X-ray phlebography, computer tomography, echocardioscopy and radionuclide phleboscintigraphy.Results. The results of surgical and combined methods of treating deep vein thrombosis in clinical subgroups were evaluated using a three-point scale - good, satisfactory and unsatisfactory. The cumulative analysis of the results of the postoperative period during 3 years of follow-up showed that good and satisfactory results were observed in 89.3% of patients of Group IA, 81.7% of patients of Group IB, 88.4% of patients of Group IC, and 35.3% of patients of Group II. Three years after treatment, the signs of chronic venous insufficiency were found in 51.6% of patients who underwent conservative treatment, 36.4% of patients who received combined treatment, 10.2% of patients who underwent partial thrombectomy, 2.9% of patients who received surgical treatment of transfascial thrombosis; they were absent in patients who underwent radical thrombectomy.Conclusions. In quantitative evaluation of the early and remote results of treating deep vein thrombosis of the inferior vena cava, a significant improvement in the patients’ condition in all parameters was observed in the main group as compared to the control one.
https://doi.org/10.21802/gmj.2018.1.11
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