Novosti
|
This journal is indexed in Scopus |
---|
Year 2015 Vol. 23 No 2
GENERAL AND SPECIAL SURGERY
E.Y. SOLDATSKY, S.M. YUMIN, A.V. ANDRIYASHKIN, I.A. ZOLOTUKHIN, A.I. KIRIENKO
COMPARISON OF THE LONG -TERM OUTCOMES OF FEMOROPOPLITEAL DEEP VENOUS THROMBOSIS
Russian National Research Medical University named after N.I. Pirogov, Moscow,
The Russian Federation
Objectives. To study the long-term outcomes of femoropopliteal deep venous thrombosis and to compare them with the clinical results after an isolated distal deep vein thrombosis.
Methods. The case-control study with a pair design has been carried out. 88 patients were enrolled in the study treated for deep venous thrombosis (DVT) of the femoropopliteal (the main group, n=44) and distal segments (the control group, n=44). Patients’ examination included anamnesis taking, physical examination, analysis of available medical records, questioning using questionnaire CIVIQ2 (the quality of life), ultrasound angioscanning of the veins.
Results. According to the incidence of risk factors detection such as trauma, oncological diseases, congenital thrombophilia, air flight, hormonal drugs, no statistically significant differences were found (p>0,05). Overweight was frequently detected in the main group (p=0,039). In the control group the number of patients subjected DVT shortly prior surgery (p=0,039) was 2-fold higher.
The recurrence rate (the same 2-fold higher) in the study group was – 9% (p=0,398). There were 14 cases (32%) of pulmonary embolism in the main group and 4 cases (9%) in the control group (p=0,0021). Commitment to treatment was higher in patients of the main group. The incidence of chronic venous insufficiency (classes C3-C6 by CEAP) in the main group was 73% and 17% - in the control group (p=0,001). An additional evaluation criterion was index of venous disease severity by VCSS scale. Its average values was 4,6% in the main group and 3,3% in the control group (p=0,004). The differences were statistically significant. The groups didn’t differ statistically according to the level of life quality.
Conclusion. Venous thrombosis of femoropopliteal localization according to its clinical outcomes differs from distal deep vein thrombosis and leads to more expressed manifestation of post-thrombotic diseases. From the point of life quality there are no differences between the femoropopliteal and distal deep vein thrombosis.
- Zolotukhin IA, Iumin S M, Leont'ev S G, Andriiashkin AV, Kirienko AI. Otdalennye rezul'taty lecheniia patsientov, perenesshikh tromboz glubokikh ven nizhnikh konechnostei [The long-term results of treatment of patients undergoing deep vein thrombosis of the lower extremities]. Flebologiia / Flebologiia 2011;(1):27-33. Available from: http://www.mediasphera.ru/journals/flebo/746/11725/.
- Eichinger S, Heinze G, Jandeck LM, Kyrle PA. Risk assessment of recurrence in patients with unprovoked deep vein thrombosis or pulmonary embolism: the Vienna prediction model. Circulation. 2010 Apr 13;121(14):1630-36. doi: 10.1161/CIRCULATIONAHA.109.925214.
- Palareti G, Schellong S.Isolated distal deep vein thrombosis: what we know and what we are doing. J Thromb Haemost. 2012 Jan;10(1):11-9. doi: 10.1111/j.1538-7836.2011.04564.x.
- Kahn SR, Shbaklo H, Lamping DL, Holcroft CA, Shrier I, Miron MJ, Roussin A, Desmarais S, Joyal F, Kassis J, Solymoss S, Desjardins L, Johri M, Ginsberg JS. Determinants of health-related quality of life during the 2 years following deep vein thrombosis. J Thromb Haemost. 2008 Jul;6(7):1105-12. doi: 10.1111/j.1538-7836.2008.03002.x.
- Roberts LN, Patel RK, Chitongo PB, Bonner L, Arya R. Presenting D-dimer and early symptom severity are independent predictors for post-thrombotic syndrome following a first deep vein thrombosis. Br J Haematol. 2013 Mar;160(6):817-24. doi: 10.1111/bjh.12192.
- Roberts LN, Patel RK, Donaldson N, Bonner L, Arya R. Post-thrombotic syndrome is an independent determinant of health-related quality of life following both first proximal and distal deep vein thrombosis. Haematologica. 2014 Mar;99(3):e41-3. doi: 10.3324/haematol.2013.089870.
- Galanaud JP, Bosson JL, Quéré I. Risk factors and early outcomes of patients with symptomatic distal vs. proximal deep-vein thrombosis. Curr Opin Pulm Med. 2011 Sep;17(5):387-91. doi: 10.1097/MCP.0b013e328349a9e3.
- Scarvelis D, Wells PS.Diagnosis and treatment of deep-vein thrombosis. CMAJ. 2006 Oct 24;175(9):1087-92.
- Launois R, Reboul-Marty J, Henry B.Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ). Qual Life Res. 1996 Dec;5(6):539-54.
- Partsch HA. New classification scheme of chronic venous disease in the lower extremities. The CEAP–system. Phlebolymphology. 1995;(10):3-8.
- Galanaud JP, Quenet S, Rivron-Guillot K, Quere I, Sanchez Munoz-Torrero JF, Tolosa C, Monreal M. Comparison of the clinical history of symptomatic isolated distal deep vein thrombosis vs. proximal deep vein thrombosis in 11 086 patients. J Thromb Haemost. 2009 Dec;7(12):2028-34. doi: 10.1111/j.1538-7836.2009.03629.x.
- Baglin T, Douketis J, Tosetto A, Marcucci M, Cushman M, Kyrle P, Palareti G, Poli D, Tait RC, Iorio A.Does the clinical presentation and extent of venous thrombosis predict likelihood and type of recurrence? A patient-level meta-analysis. J Thromb Haemost. 2010 Nov;8(11):2436-42. doi: 10.1111/j.1538-7836.2010.04022.x.
- Eichinger S, Heinze G, Jandeck LM, Kyrle PA. Risk assessment of recurrence in patients with unprovoked deep vein thrombosis or pulmonary embolism: the Vienna prediction model. Circulation. 2010 Apr 13;121(14):1630-36. doi: 10.1161/CIRCULATIONAHA.109.925214.
- Palareti G, Schellong S.Isolated distal deep vein thrombosis: what we know and what we are doing. J Thromb Haemost. 2012 Jan;10(1):11-19. doi: 10.1111/j.1538-7836.2011.04564.x.
- Prandoni P, Lensing AW, Prins MH, Frulla M, Marchiori A, Bernardi E, Tormene D, Mosena L, Pagnan A, Girolami A.Below-knee elastic compression stockings to prevent the post-thrombotic syndrome: a randomized, controlled trial. Ann Intern Med. 2004 Aug 17;141(4):249-56.
117049, Rossiyskaya Federatsiya,
g. Moskva, Leninskiy prospekt d. 10, korp. 5,
"Rossiyskiy natsionalnyiy issledovatelskiy meditsinskiy universitet
im. N.I. Pirogova", kafedra fakultetskoy khirurgii №1,
tel. office: 7-910-474-95-11,
e-mail: netbobr@bk.ru,
Soldatsky Evgeniy Yurevich
Soldatsky E.Y. A post-graduate student of the faculty surgery chair N1 of the medical faculty of Russian National Research Medical University named after N.I. Pirogov.
Yumin S.M. PhD, an assistant of the faculty surgery chair N1 of the medical faculty of Russian National Research Medical University named after N.I. Pirogov.
Andriyashkin A.V. PhD, an associate professor of the faculty surgery chair N1 of the medical faculty of Russian National Research Medical University named after N.I. Pirogov.
Zolotukhin I.A. MD, professor of the faculty surgery chair№1 of the medical faculty of Russian National Research Medical University named after N.I. Pirogov.
Kirienko A.I. MD, professor, Academician of RAMS, a head of the faculty surgery chair N1 of the medical faculty of Russian National Research Medical University named after N.I. Pirogov.