SURGICAL TREATMENT OF FLOATING THROMBOSIS OF INFERIOR VENA CAVA SYSTEM

During 2009-2014 in the department of vascular surgery of the Amur regional clinical hospital there were 5293 operation, and 187 (3.5%) of patients were operated on about floating thrombosis of different localization. The mean age of the patients was 55 years old, among them there were 101 men (54%) and 86 women (46%). The majority of patients (74.5%) were operated on during the first day of their getting into hospital. 135 patients (72%) were registered to have a subacute period of venous thrombosis. In 67 (35.7%) patients the floating thrombus was in the ileac-caval part of inferior vena cava system. The delegation of external iliac vein was done in 60 (32%) of cases, retrograde thrombectomy from the iliac segment in 1 (0.5%) patient, retrograde thrombectomy from the iliac segment with the arteriovenous fistulization in the femur area in 1 (0.5%) case, isolated delegation of general iliac vein in 5 (2.8%) patients. The superficial femoral vein was operated in 49 (25.6%) patients including isolated delegation in 39 (21%), the plication of superficial femoral vein in 7 (3.7%). In 3 (1.6% of cases) the delegation of superficial femoral vein was combined with crossectomy of great saphenous vein, in 1 (0.5%) it was with crossectomy of small saphenous vein of the opposite extremity. There were 13 (6.7%) operations on the inferior vena cava. Among them there were 9 thrombectomies from the suprarenal part of inferior vena cava, including 1 (0.5%) isolated, 1 (0.5%) in combination with thrombecotomy from the right compartments of the heart, 1 (0.5%) with embolectomy from pulmonary arteries in the conditions of temporary occlusion of vena cava and delegation of ifrarenal part of vena cava; 1 (0.5%) with the delegation of ifrarenal part of the inferior vena cava and the removal of Vena-Cava Filter; 4 (2.1%) with the delegation of infrarenal part of inferior vena cava and nephrectomy; 1 (0.5%) with alloprosthesis of suprarenal part of the inferior vena cava. Thrombectomy from the renal part and nephrectomy were done in 1 (0.5%) patient. Because of the retroperitoneal hematoma 3 (1.6%) patients were operated. 3 (1.6%) patients died because of the repeated thrombosis of inferior vena cava system and recurrent thromboembolization of pulmonary arteries. Active surgical tactics in patients with floating thrombosis of inferior vena cava system allows to save life in 98.4% cases.

венозный тромбоз, венозные тромбоэмболические осложнения, нижняя полая вена, тромбоэмболия легочных артерий, venous thrombosis, venous thromboembolic complications, vena cava inferior, thromboembolism of pulmonary artery

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