Тромбоз, гемостаз и реология

Tromboz, Gemostaz I Reologiya
scientific and practical journal

ISSN 2078–1008 (Print); ISSN 2687-1483 (online)
2024, Original papers
2024

Conservative and surgical treatment of deep vein thrombosis: choice of the professional surgical community: 616‐005.6:617‐089

Original papers
Published 2024-10-11
Sergey M. Markin
Saint Petersburg Clinical Hospital, Russian Academy of Sciences; 72 Prospekt Toreza, Saint Petersburg 194017, Russia;
ФГБУЗ «Санкт-Петербургская клиническая больница» Российской академии наук; Россия, 194017 Санкт-Петербург, проспект Тореза, 72 лит. А;
Pavel F. Kravtsov
Samara State Medical University, Ministry of Health of the Russian Federation; 89 Chapaevskaya Str., Samara 443099, Russia;
ФГБОУ ВО «Самарский государственный медицинский университет» Министерства здравоохранения Российской Федерации; Россия, 443099 Самара, Чапаевская ул., 89;
https://orcid.org/0000-0002-1283-5342 (unauthenticated)
Anastasia S. Artemova
Multi-field Medical and Diagnostic Center Lakhta Clinic LLC; 50 Dibunovskaya Str., Saint Petersburg 197183, Russia;
ООО Многопрофильный медицинский и диагностический центр «Лахта Клиника»; Россия, 197183 Санкт-Петербург, Дибуновская ул., 50, лит. А;
https://orcid.org/0000-0003-4885-8156 (unauthenticated)
Evgeny A. Ilyukhin
Medalp Clinic LLC; 54 Leningradskaya Str., Poselok Pesochny, Saint Petersburg 194295, Russia
Клиника ООО «Медальп»; Россия, 194295 Санкт-Петербург, посёлок Песочный, Ленинградская ул., 54
https://orcid.org/0000-0002-8288-8239 (unauthenticated)

Keywords

deep vein thrombosis
DVT
surgery
vena cava filter
anticoagulant therapy
АСТ
  Full Text

Abstract

Summary. Introduction. Deep vein thrombosis (DVT) is an acute condition caused by the formation of thrombi in the lumen of the vein. The DVT incidence ranges from 45 to 117 cases per 100,000 population. The high incidence of this nosology has prompted the numerous randomized studies aimed at improving treatment outcomes for the disease and reducing the risk of adverse consequences. The findings of the most significant studies served as the foundation for the Clinical Guidelines of the Association of Phlebologists of Russia in 2023. Aim: to determine the level of awareness among the members of professional surgical community regarding the diagnosis and treatment of DVT. Materials and Мethods. In advance of the online seminar “Deep Vein Thrombosis: Is There a Room for Surgery?”, held on the educational platform “Actual Phlebology” on September 5, 2023, a survey of professional community participants was conducted. A total of 102 respondents took part in the survey: 40 vascular surgeons and phlebologists, 17 general surgeons, 3 ultrasound/functional diagnostics physicians, 1 therapist and 1 Х‐ray endovascular diagnostics and treatment specialist. The respondents were proposed to answer 11 questions pertaining to the diagnosis and treatment of patients with DVT. Results. The vast majority of respondents (99%) reported encountering patents with DVT at the time of their appointment. A majority of respondents (98%) indicated that they would select anticoagulant therapy (АСТ) as the preferred treatment method for such patients. A total of 97% of respondents believe that АСТ is aimed at halting the pathological process of thrombus formation. The indications for early deobstruction are determined by the involvement of the iliac segment (86%). According to 79% of respondents, stenting after desobstruction is mainly indicated for the residual stenosis of more than 50%. At the same time, the majority of respondents (77.5%) are not ready to reduce the АСТ duration after disobstructive procedures. According to 86% of specialists, the inability to prescribe АСТ is an indication for the vena cava filter implantation. The respondents demonstrated a variety of approaches to the timing of anticoagulation and medication preferences. However, there are general trends in relation to the management of cancer and “fragile” patients. Conclusion. The professional community has demonstrated heterogeneity in understanding the role and place of surgical treatment for DVT. Consequently, АСТ is justifiably perceived as the mainstay of DVT therapy

For citation: Markin S.M., Kravtsov P.F., Artemova A.S., Ilyukhin E.A. Conservative and surgical treatment of deep vein thrombosis: choice of the professional surgical community. Tromboz, gemostaz i reologiya. 2024;(3):19–27. (In Russ.).

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