Deep vein thrombosis is one of the most formidable conditions, which can subsequently cause pulmonary embolism and trigger the development of post-thrombophlebitic disease. The aim of our work was to evaluate the result of antegrade venous thrombectomy with stenting for acute iliofemoral phlebothrombosis in a patient with post-thrombophlebitic disease. PatientG., 33years old, was admitted to the Department of Vascular Surgery of the City Clinical Hospital No.7 of Kazan on January1, 2021 on an emergency basis with complaints of severe swelling and pain in the right lower limb.Upon admission, the patient underwent ultrasound Doppler scanning of the veins of both lower extremities and X-ray tomography of the chest and abdominal cavities with contrast, according to which the diagnosis of acute iliofemoral phlebothrombosis on the right with thrombus flotation in the common iliac vein for 7cm was made. According to vital indications, the surgery transjugular thrombectomy from the iliofemoral segment using a proximal venous trap and subsequent implantation of a venous stent into the right common iliac vein was performed. In the postoperative period, the patient received anticoagulant therapy. Aday after the operation, a control ultrasound of the veins of the lower extremities and the inferior vena cava, X-ray tomography of the organs of the chest and abdominal cavity were performed. On the 5th day, the patient was discharged in asatisfactory condition under the supervision of a surgeon at the place of residence. Analysis of the results of surgical treatment of a patient with post-thrombophlebitic disease complicated by acute iliofemoral phlebothrombosis using antegrade venous thrombectomy with stenting showed that the patency of the stented iliac-femoral segment was maintained for up to 12months. Thus, the proposed method of surgical treatment allows us to safely remove floating and occlusive thrombi from the iliocaval and femoral segments, implant stents, and thereby restore the patency of the segment, reducing the risk of possible repeated thrombosis, embolic and post-thrombophlebitic complications.

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Aim. To describe a case of arterial thrombosis with a thrombus that had atypical composition due to profound pathological changes in the cellular and protein composition of the blood. Methods. Scanning electron microscopy of an ex vivo thrombus extracted from the common femoral artery. Results. In the absence of platelets and leukocytes there was a significant prevalence of fibrin over other blood components in all layers of the arterial thrombus. There were no morphological signs of intravital contraction (retraction) characteristic for thrombi: single erythrocytes were not exposed compressive deformation, redistribution of fibrin and platelets within the thrombus toward the periphery. Formation of the atypical arterial thrombus in the vessel with atherosclerotic vessel damage is probably due to association with severe hyperfibrinogenemia and thrombocytopenia. Conclusion. The structure of a thrombus depends not only on its vascular location (arterial or venous), but also on the cellular and protein composition of the blood. These factors support diversification of antithrombotic therapy, considering composition and properties of thrombi irrespective of the place and hemodynamic conditions of their formation.