Thrombosis of perforating veins: frequence, structure, features of treatment and connection with cancer

Abstract

Acute varicose vein thrombosis is one of the main varicose disease complications. It causes deep vein thrombosis in 10 — 25 % and pulmonary embolism — in 10 % of patients.The aim — to study the frequency, nature, distribution of non‑systemic varicositosis of the lower extremities and the features of its treatment, as well as to establish its connection with oncological diseases.Materials and methods. For the period of 2010 — 2015, 546 patients with acute varicotrombosis were hospitalized, 28 of them (5.1 %) — with varicotrombosis outside the system of the large or small saphenous vein. 13 of them were men (46.4 %) and 15 — women (53.6 %). The average age of the patients was 48.2 years, the average period of existence of varicose veins — 12 years, the average duration of illness — 5.2 days. All patients underwent duplex vascular scaning, general clinical examinations and initial search for cancer.Results and discussion. Thrombosis of varicose veins which were connected with deep veins through perforating veins was found in all patients. Flotation into deep veins was found in 13 (43.6 %) cases, perforating vein thrombosis — in 11 (39.3 %), thrombosis of varicose branch of the perforating vein system — in 4 (17.9 %) cases. 24 (85.7 %) patients had a surgery, 4 (14.3 %) were treated conservatively. Malignancy was identified in 5 (17.9 %) patients for the first time in their lives after the conducted search for cancer.Conclusions. Frequency of perforating vein thrombosis constituted 5.1 %, progression of perforating vein thrombosis to deep vein thrombosis — 46.4 %.The main method of treatment is surgery in order to prevent progression of perforating vein thrombosis to deep vein thrombosis and pulmonary embolism. The presence of malignancy in patients with non‑systemic varicotrombosis was 17.9 %.