Novosti
Khirurgii
This journal is
indexed in Scopus



Научно-практическая конференция с международным участием и
XXVIII Пленум Правления Белорусской ассоциации хирургов
«Актуальные вопросы и современные подходы в оказании
хирургической помощи в Республике Беларусь»
18-19 ноября 2021 года в г. Минск.






Year 2015 Vol. 23 No 1

GENERAL AND SPECIAL SURGERY

DOI: http://dx.doi.org/10.18484/2305-0047.2015.1.57   |  

Y.T. TSUKANOV, A.I. NIKOLAYCHUK

EVALUATION OF FACTORS AFFECTING THROMBUS REGRESSION OF SUBCUTANEOUS VEINS OF THE LOWER LIMBS IN ANTICOAGULATION THERAPY

SEE HPE "Omsk State Medical Academy",
The Russian Federation

Objectives. To assess the factors affecting the thrombus regression using anticoagulants in patients with subcutaneous venous thrombosis.
Methods. 65 patients receiving anticoagulants in the adjuvant therapy within 1-14 days, (on the average 5,05 days) after thrombosis development have been examined. An evaluation of thrombus changes, venous wall and paravasal cellulose was perfomed by duplex ultrasonography.
Results. Mass and density of thrombus, distal displacement of its borders, reduction of inflamed venous wall and paravasal cellular tissue have been reduced in all patients. Regression began in 1-10 days (on the average 5,37 day). Depending on the rate of regression, the observations are divided into two subgroups: 1) relatively quick - within a week (16), and 2) relatively slow – within a month (49 people). It has been found out that treatment with anticoagulants started up to 3 days, low echodensity of the proximal part of thrombus, cellular character, unexpression of paravasal inflammation throughout the thrombus and its proximal part make the significant probability of rapid thrombus regression (p=0,000001).
Conclusion. Thrombosis regression of the subcutaneous veins in the treatment process, including anticoagulants, in the nearest terms passes the way of thrombolysis with a minimal damage of the venous wall by reducing its mass and density, increasing its cellular structure. Rapid regression of the proximal part of the subcutaneous vein thrombus occurs in treatment beginning up to 3 days from the moment of a blood clot formation, its low echodensity, thickness of the inflamed paravasal tissue in the proximal part of the blood clot not more than 5 mm and for thrombus not more than 7 mm. In case of ligation of large subcutaneous veins to prevent the pulmonary embolism a clot lysis slows down.

Keywords: subcutaneous vein thrombosis, anticoagulants, regression of thrombosis, thrombolysis
p. 57-62 of the original issue
References
  1. Wichers IM, Di Nisio M, Büller HR, Middeldorp S. Treatment of superficial vein thrombosis to prevent deep vein thrombosis and pulmonary embolism: a systematic review. Haematologica. 2005 May;90(5):672-77.
  2. Decousus H, Quéré I, Presles E, Becker F, Barrellier MT, Chanut M, Gillet JL, Guenneguez H, Leandri C, Mismetti P, Pichot O, Leizorovicz A. Superficial venous thrombosis and venous thromboembolism: a large, prospective epidemiologic study. Ann Intern Med. 2010 Feb 16;152(4):218-24.
  3. Barrellier MT. Superficial venous thromboses of the legs. Phlebologie. 1993 Oct-Dec;46(4):633-39.
  4. Gillet JL, Allaert FA, Perrin M. Superficial thrombophlebitis in non varicose veins of the lower limbs. A prospective analysis in 42 patients. [Article in French]. J Mal Vasc. 2004 Dec;29(5):263-72.
  5. Di Nisio M, Wichers IM, Middeldorp S. Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD004982.
  6. Shabunin AV, Gavrilov SG, Pustovoit AA, Bychkova TV, Karalkin AV, Zolotukhin IA. Sravnenie effektivnosti khirurgicheskoi i konservativnoi taktiki pri ostrom voskhodiashchem varikotromboflebite bol'shoi podkozhnoi veny [Comparison of the effectiveness of surgical and conservative management for acute ascending varikotromboflebite of great saphenous vein]. Flebologiia. 2013;(2):10-14.
  7. Kalodiki E, Stvrtinova V, Allegra C, Andreozzi G, Antignani PL, Avram R, Brkljacic B, et al. Superficial vein thrombosis: a consensus statement. Int Angiol. 2012 Jun;31(3):203-16.
  8. Decousus H, Prandoni P, Mismetti P, Bauersachs RM, Boda Z, Brenner B, Laporte S, Matyas L, Middeldorp S, Sokurenko G, Leizorovicz A; CALISTO Study Group. Fondaparinux for the treatment of superficial-vein thrombosis in the legs. N Engl J Med. 2010 Sep 23;363(13):1222-32.
  9. Zwiebel William J, Pellerito John S. Introduction to Vascular Ultrasonography, 5th Edition. Saunders (W.B.) CoLtd; 2004. 752 p.
  10. Kirienko AA, Matiushenko VV, Andriiashkin VV. Ostryi tromboflebit [Acute thrombophlebitis]. Moscow, RF: Litterra; 2006. 108 p.
  11. Davydovskii IV. Obshchaia patologiia cheloveka [General human pathology]. Meditsina, USSR; 1969. 612 p.
  12. Markel A, Meissner M, Manzo RA, Bergelin RO, Strandness DE Jr.
    Deep venous thrombosis: rate of spontaneous lysis and thrombus extension. Int Angiol. 2003 Dec;22(4):376-82.
  13. Piovella F, Crippa L, Barone M, Viganò D'Angelo S, Serafini S, Galli L, Beltrametti C, D'Angelo A. Normalization rates of compression ultrasonography in patients with a first episode of deep vein thrombosis of the lower limbs: association with recurrence and new thrombosis. Haematologica. 2002 May;87(5):515-22.
  14. Klement AA, Vedenskii AN. Khirurgicheskoe lechenie zabolevanii ven konechnostei [Surgical treatment of diseases of the veins of the extremities]. Leningrad, USSR: Meditsina; 1976. 295 p.
Address for correspondence:
644043, Rossiyskaya Federatsiya,
g. Omsk, ul. Lenina, d. 12,
GOU VPO "Omskaya gosudarstvennaya
meditsinskaya akademiya",
kafedra khirurgicheskih bolezney i urologii PDO,
tel. office 7 3812 36-07-62,
e-mail: alex79nik@mail.ru,
Nikolaychuk Aleksandr Ivanovich
Information about the authors:
Tsukanov Y.T. MD, professor, a head of the surgical diseases and urology chair of SBEE HPE "Omsk State Medical Academy".
Nikolaychuk A.I. An assistant of the surgical diseases and urology chair of SBEE HPE "Omsk State Medical Academy".
Contacts | ©Vitebsk State Medical University, 2007