Surgical treatment of iliofemoral phlebothrombosis using transjugular thrombextraction

• Khuziakhmedov A.N.
• Khalilov I.G.
• Komarov R.N.

Abstract

Objective. The study was aimed at reducing the risk for the development of intraoperative embolism during thrombectomy from the iliofemoral venous segment.

Danger of surgical treatment of patients with phlebothrombosis of the iliofemoral segment with flotation remains of current concern primarily due to the risk of pulmonary embolism. The authors worked out a method of surgical treatment making it possible to decrease the risk of this complication.

This method was used in a total of 34 patients diagnosed with acute deep vein thrombosis. All patients, both preoperatively and in the early postoperative period, underwent chest and abdominal contrast-enhanced X-ray computed tomography, ultrasonographic duplex scanning of veins of both lower limbs. After making the final diagnosis, all patients were subjected to surgical treatment: transjugular thrombectomy from the iliocaval and femoral segments, with no postoperative complications observed. All patients were discharged in a satisfactory condition to be followed up by district surgeon. The iliofemoral segment remained patent during the whole follow-up period, with no evidence of rethrombosis.

Conclusion. The developed method of transjugular thrombextraction from the iliocaval and femoral segments for phlebothrombosis makes it possible to safely restore patency of veins in the involved segment with minimal risk of both intra- and postoperative complications.

Keywords:floating thrombus; inferior vena cava thrombosis; iliofemoral thrombosis; lower-limb deep vein thrombosis, thromboextractor

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