Abstract

The OBJECTIVE was to assess the effectiveness of the developed method for treating DVT with fibrinolytic agent injection via a catheter with multiple openings along the length of entire thrombus. METHODS AND MATERIALS. The analysis of treatment efficacy of 40 patients with late total and subtotal deep vein thrombosis was carried out. The patients were divided into two statistically valid groups. The first group of patients were treated using regional thrombolysis by injection of Urokinase into the popliteal vein. The second group had fibrinolytic agent injection via a catheter with multiple openings passed along the entire length of thrombosed venous segment. Patients were given Rivaroxaban before, during, and after the therapy continuously for 6 months. RESULTS. After 1 year in the second group, compared to the first group, the excellent and good results were higher by 10 % and 5 % respectively. Satisfactory and unsatisfactory results decreased by 10 and 5 % respectively. While using background Rivaroxaban, the thromboembolic complications were not registered. Hemorrhagic complications were found in 10 % of both group patients with equal rate. CONCLUSION. Injection of a fibrinolytic agent via a catheter with multiple openings along the length of entire thrombus is efficient and pathogenetically substantiated.

Highlights

  • Received 05.11.19; accepted 05.02.20 The OBJECTIVE was to assess the effectiveness of the developed method for treating DVT with fibrinolytic agent injection via a catheter with multiple openings along the length of entire thrombus

  • Hemorrhagic complications were found in 10 % of both group patients with equal rate

  • The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study

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Summary

Clinical and demographic characteristics of patients

В рентгенооперационной в положении больного лежа на животе под ультразвуковым контролем проводили пункцию подколенной вены по методике Сельдингера и выполняли восходящую контрастную флебографию для уточения распространенности тромботического процесса. В просвет подколенной вены вводили проводник, а по нему – катетер Cragg – McNamara или Fontain 5 F. При помощи инфузионного насоса в просвет тромбированной подколенной вены вводили препарат Урокиназа со скоростью 82 000–84 000 МЕ/ч. По интродьюсеру катереры под рентгенологическим контролем проводили через весь тромбированный сегмент глубоких вен по задней больше­ берцовой, подколенной, бедренной и подвздошной венам. Отдаленные результаты лечения оценивали через 1 год после РКТ путем проведения клинического и ультразвукового исследования венозной системы нижних конечностей пациента. При ультразвуковом исследовании венозной системы восстановление просвета глубоких вен оценивали по общепринятой в мировой практике шкале: менее 50 % – минимальное, 50–99 % – частичное, 100 % – полное. Статистическую обработку проводили с использованием аналитического пакета приложения «ExcelOffice 2010»

Степень проходимости
Степень ХВН
Соответствие нормам этики
Findings
Compliance with ethical principles

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