COLATERAL BLOOD FLOW AT THROMBOSIS IN THE FEMORAL VENOUS COLLECTOR

Abstract

Anatomical features of collateral circulation of a hip influence on the severity of a clinical picture at deep thromboses and play a role in the prevention of complications. This necessitates the assessment of collateral blood flow.
 The aim of research: to evaluate the compensatory possibilities of the collateral blood flow in the femoral venous collector in the acute venous thrombosis.
 Methods. The analysisis made of results examination and treatment of 790 patients with the acute thrombosis in the vena cava inferior system and being treated at the Transcarpathian Regional Clinical Hospital named after A. Novak and the Transcarpathian Regional Clinical Oncology Center during 2006–2016. The laboratory methods and the instrumental ones (ultrasound duplex scanning, X-ray phlebography, computed tomography, radionuclide flebo scintigraphy and ultrasound scanning of heart) were used for investigation of patients,
 Results of research. Deep vein thrombosis in the popliteal-femoral segments was observed in 322 (40.8%) of 790 patients. At the occlusion of the popliteal-femoral segments in the collateral blood flow take part the next vessels: superficial (large subcutaneous vein, small subcutaneous vein, posterior cutaneous femoral vein) and deep (deep femoral vein, vein-satellites of the main arteries, popliteal-femoral-sciaticpath, v. articularis genusuprema, vv. comitans n. ischiadici and abnormal femoral collateral), which quickly off set violations.
 At the spread of thrombosis to general femoral vein, the clinical picture of the disease becomes more pronounced, due to the exclusion from the blood flow of deep femoral vein and most superficial venous collaterals (posterior cutaneous femoral vein and large subcutaneous vein), which leads to a sharp decompensation of venous outflow.
 Conclusions. At the deep vein thrombosis in the popliteal-femoral segment the venouscollaterals, whichin 98.4% of cases occur secondarily, quickly compensate for hemodynamicdisorders, but at progression of thrombosis and exclusion of deep femoral and large subcutaneous veins in popliteal-femoral segments the decompensation of venous blood flow rapidly.
 Thrombosis of deep veins in the popliteal-femoral segment occurs secondarily, due to the spread of thrombotic masses from the tibial veins. The jugular vein share the source of thrombosis in only 1.6% of patients.
 At occlusion of a popliteal-femoral venous segment in collateral blood flow the following vessels participate: superficial (LSV, SSV, a back cutaneousvein of a hip) and deep (DFV, veins-satellites of the main arteries, popliteal-femoral-sciatic way, v. Articularis us vv. comitans n. Ischiadici and abnormal femoral collaterals), which quickly eliminate hemodynamic disturbancesin the popliteal-wall segment.
 The most pronounced clinical symptoms of deep vein thrombosis in the popliteal-femoral segment are observed when excluding from the collateral blood flow of the deep femoral and great saphenous veins.