An Integrated Approach to the Treatment of Pulmonary Embolism: Current State of the Problem

Khrebtiy, Yaroslav V.

doi:10.30702/ujcvs/22.30(02)/kh026-3943

Cited by 6 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

Section: патологія периферичної судинної системиmentioning

confidence: 99%

“…Results of previous studies suggest that patients with a hip fracture have considerably high prevalence of preoperative VTE ranging from 9% to 12.7% [3]. Despite the use of modern approaches and technologies for the prevention and treatment of VTE, the level of thromboembolic complications remains high [4,5,6].Materials and methods. The treatment of 1915 patients with fractures of lower extremities at the Vinnytsia Regional Pyrohov Clinical Hospital from 2017 to 2022 was analyzed.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Venous Thromboembolism in Trauma Patients: Features and Possibilities

Khrebtiy

Чернуха

Skupyy

et al. 2023

ujcvs

Self Cite

View full text Add to dashboard Cite

The aim. Treatment of venous thromboembolism continues to be one of the most controversial problems of modern angiology. This issue is especially relevant in the treatment of patients with traumatological pathology. Methods. Treatment of 1915 patients with fractures of lower extremities from 2017 to 2022 at the Vinnytsia Regional Pyrohov Clinical Hospital was analyzed. During the study period, 727 (38%) deep vein thromboses were diagnosed. Results. During the study period, 4 (0.2%) pulmonary embolisms were diagnosed, among which 3 (0.15%) were fatal. In 99.5% of patients with venous thrombosis and injuries, it was possible to achieve clinical improvement and regression of the thrombotic process. Conclusions. Treatment tactics for trauma patients with venous thromboembolism should be individualized and take into account the severity and localization of the injury, the need and urgency of trauma surgery, the risk of pulmonary embolism.

show abstract

Section: патологія периферичної судинної системиmentioning

confidence: 99%

mentioning

confidence: 99%

Treatment of Venous Thromboembolism in Trauma Patients: Features and Possibilities

Khrebtiy

Чернуха

Skupyy

et al. 2023

ujcvs

Self Cite

View full text Add to dashboard Cite

show abstract

“…Не дивлячись на те, що оцінки фінансових витрат на медицину суттєво варіюють, витрати від ВТЕ в США є неймовірні, і сягають до 10 мільярдів доларів протягом року [22]. У лікуванні венозного тромбоемболізму використовують як консервативні, так і хірургічні методи [3,7,8,13,14,15].…”

Section: вступunclassified

Features of treatment of venous thromboembolism in patients with abnormalities in the development of the vena cava inferior

Khrebtiy¹

2023

Rep. of Vinnytsia Nation. Med. Univ.

View full text Add to dashboard Cite

Annotation. In the treatment of venous thromboembolism, a special place is occupied by patients with congenital anomalies of the development of the inferior vena cava (IVC). To date, only single cases of treatment of this pathology have been described in the literature. Studying the experience of treating patients with congenital anomalies of the IVC will allow to improve the results of treatment of this category of patients. We analyzed the results of treatment of 1243 patients with venous thromboembolism from 2010 to 2022. For the diagnosis of venous thromboembolism, we used duplex scanning of the veins of the lower extremities, phlebography by spiral computed tomography (SCT), angiopulmonography, and phlebography. 32 (2.5%) patients had bilateral thrombosis of the ileofemoral venous segment. Congenital anomalies of IVC development were diagnosed in 2 (0.16%) patients. One patient had IVC aplasia, the other had IVC hypoplasia. Both patients had bilateral ileofemoral phlebothrombosis. For the treatment of patients with congenital anomalies of IVC and bilateral ileofemoral deep vein thrombosis, we used anticoagulant therapy and elastic compression of the lower extremities. During the study period, venous thromboembolic complications in the form of pulmonary embolism were not recorded, fatal complications were not diagnosed. Massive bleeding was not diagnosed in this category of patients during the study period. Thus, the conducted analysis allows us to state that the use of anticoagulant therapy allows to obtain satisfactory results of treatment of patients with congenital abnormalities of the development of the IVC.

show abstract

“…Однією з актуальних та найменш вирішених проблем сучасної флебології попри шалений ріст та розвиток сучасних технологій у хірургії судин залишається лікування венозних тромбозів. Рівень виникнення ускладнень тромбозів глибоких вен -тромбоемболії легеневої артерії та посттромбофлебітичного тромбозу -залишається критично високим [1]. У світі, на жаль, відсутні рандомізовані дослідження щодо визначення чітких тактичних підходів до лікування флотуючих венозних тромбозів, у багатьох випадках рішення про вибір хірургічної тактики лікарі приймають, базуючись на власному досвіді.…”

unclassified

A Differentiated Approach in the Treatment of Acute Floating Venous Thrombosis of the Inferior Vena Cava System

Khrebtiy¹

2023

Scientific and practical journal

View full text Add to dashboard Cite

We analyzed the results of surgical treatment floating DVT. Unfortunately, there are no randomized studies in the world regarding the determination of clear tactical approaches to the treatment of floating venous thrombosis, in many cases doctors make decisions about the choice of surgical tactics based on their own experience. In our research, we tried to systematize our own experience and form the basic principles of determining surgical tactics in the treatment of floating venous thrombosis. To date, anticoagulants, surgical interventions in the form of thrombectomy, and thrombolytic therapy are used in the treatment of DVT. Unfortunately, at the moment, no consensuses clearly define the issues of surgical treatment of floating venous thrombosis, venous thrombosis in pregnant women, venous thrombosis complicated by pulmonary embolism, venous thromboembolism. The goal. The aim of the research was to develop a surgical tactics in the treatment of floating DVT of the inferior vena cava. Materials and methods. The treatment of 76 patients with floating DVT from 2008 to 2020 were analyzed. In a research among patients with floating DVT in 15(20%) patients experienced thrombosis of the inferior vena cava, 19(25%) patients had ilio-femoral thrombosis in 17(22%) patients with femoral - popliteal thrombosis in 9(12%) patients with popliteal - tibial. Deep vein thrombosis complicated by pulmonary embolism with medium and high risk of death was observed in 10 (13%) patients. Among them, floating thrombosis of the iliac-femoral segment was observed in 4 patients. Floating thrombosis of deep veins in pregnant women was observed in 6 (8%) patients. Among patients, 20 (296%) patients were admitted within 1 day of the onset of the disease, 30 (39%) patients on 2-3 days, 11 (14%) patients on 4-7 days, 8 on 8-14 days (11%) patients, from the 15th day - 7 (10%) patients). The results. Patients with long of floating part of the more than 4 cm, we used an active surgical tactics. In the presence of the floating thrombus a total iliac vein thrombectomy we performed in 12 patients with the removal of the floating thrombus with femoral access. For the prevention of pulmonary embolism in these cases we implanted a temporary cava-filter. When flotation thrombus in the external iliac vein, we used the technique of thrombectomy using Fogarty two catheters in 12 patients. When flotation clots in common femoral vein and distally using a vein thrombectomy with clamping head above floating thrombus. When treating patients with floating DVT, pulmonary embolism complicated with medium and high risk of death, we used systemic thrombolysis with pre- implantation temporary coffee filter in patients with floating DVT, pulmonary embolism complicated with medium and high risk of death, we used systemic thrombolysis with pre- implantation temporary coffee filter. In the presence of pregnancy and floating thrombosis thrombectomy was performed with the removal of the thrombus floating. In our research, when performing the surgical treatment of DVT no cases of pulmonary embolism during or after treatment were observed. In 100 % of patients after treatment has been a clinical improvement in all cases floating DVT was eliminated floating nature of the danger of thrombosis and pulmonary embolism. Conclusions. In the presence of a floating DVT of the inferior vena cava system with a length of the floating part of the thrombus greater than 4 cm, it is necessary to use an active strategy of thrombus removal. When performing thrombectomy, it is necessary to use methods of surgical prevention of PE, taking into account the localization of the floating part.

show abstract

An Integrated Approach to the Treatment of Pulmonary Embolism: Current State of the Problem

Cited by 6 publications

References 23 publications

Treatment of Venous Thromboembolism in Trauma Patients: Features and Possibilities

Treatment of Venous Thromboembolism in Trauma Patients: Features and Possibilities

Features of treatment of venous thromboembolism in patients with abnormalities in the development of the vena cava inferior

A Differentiated Approach in the Treatment of Acute Floating Venous Thrombosis of the Inferior Vena Cava System

Contact Info

Product

Resources

About