SURGICAL TACTICS FOR THE INFLOW VARICOTHROMOPHLEBITIS

Abstract

Purpose of the study. To develop the surgical tactics for the inflow varicothrombophlebitis.
 Methods. The paper analyzes of the examination and treatment results in 314 patients suffering the inflow varicothrombophlebitis. Localization, length, borders of thrombotic occlusion, level of proximal and distal edges of thrombotic occlusion, the thrombotic masses character, the function of the valvular apparatus of the large and small subcutaneous veins, the presence or absence of venous reflux and varicose transformation of the main trunk were estimated during ultrasound examination. The data of ultrasound examination for inflow varicothrombophlebitis made it possible to analyzes the venous hemodynamics, predict the danger of the formation of a floating tip of thrombotic masses and the rate of growth of thrombotic masses towards on the large subcutaneous vein trunk and insufficient perforant veins of the lower leg.
 Results. Detection for the inflow varicothromophlebitis during ultrasound diagnostics served as an indicator of urgent surgery due to the threat of thrombotic masses spread on the main trunk or deep venous system. Isolated operative treatment the inflow varicothrombophlebitis was performed in 158 (50,3%) patients. In 156 (49,7%) patients, the volume of surgical treatment the inflow varicothrombophlebitis was expanded in order to eliminate the chronic venous insufficiency due to varicose veins and prevent the recurrence of thrombophlebitis.
 Conclusion. Following an active surgical tactics for the inflow varicothrombophlebitis have permitted to prevent effectively the spread of thrombtotic process on the large subcutaneous vein trunk and insufficient perforant veins, as well as to prevent the development of thrombosis in deep veins and venous thromboembolism morbidity. At the same time the operation volume reduction due to the inflow thrombophlebitis presence in the patient gave a chance to preserve the intact subcutaneous vein for possible further reconstructive interventions and to prevent the chronic venous insufficiency development as well.