ENDOVASCULAR CATHETER THROMBECTOMY FROM VENA CAVA INFERIOR

V.S. Saveljev, E.G. Yablokov, V.I. Prokubovsky, S.A. Kapranov, A.S. Solonko, A.V. Dubrovsky, V.P. Burov
Faculty Surgery Clinics Russian State Medical University,
Moscow, Russia

The purpose of the study was to develop the procedure of endovascular catheter thrombectomy from inferior vena cava (IVC) system, as well as to determine its role in complex management of patients with acute venous thromboses and prevention of pulmonary thromboembolism. Endovascular catheter thrombectomy was successful in 39 patients (95.12%) from 43. Free-floating thrombi were totally extracted in 32 patients: in 28 (65.11%) – from inferior vena cava and in 4 (9.3%) – from iliac veins. In 9 cases (20.93%) ablation of free-floating portion of thrombus from inferior vena cava was partial. Only in 2 cases (4.65%) endovascular catheter thrombectomy failed. Fatal outcome occurred in 2 patients (4.65%), only in 1 case being caused by fatal perioperative complication in the period of procedure mastering. No other complications were registered. In 18 cases (41.6%) total endovascular catheter thrombectomy and adequate hemostatic effect of complex antithrombotic therapy withdrew the necessity of additional cava filter implantation. In the rest 23 patients (53.48%) endovascular intervention was ended by implantation of permanent (17 cases) or removable (6 cases) cava filters, including 2 removed in post-treatment period. In long-term follow-up 39 patients (90.69%) were re-examined in period from 1 to 12 months after procedure with 3 months interval. In total short- and long-term outcome recurrent IVC thrombosis with deep vein lesions in contralateral limb was observed in 8 patients (20.51%), pulmonary thromboembolism – in 4 patients (10.25%).

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