Kazan medical journalKazan medical journal0368-48142587-9359Eco-Vector10038410.17816/KMJ100384Research ArticleThe use of antegrade venous thrombectomy with stenting for acute iliofemoral phlebothrombosis in a patient with post-thrombophlebitis diseaseKhuziakhmedovAnvar N.<p>cardiovascular surgeon, Depart. of Vascular Surgery; M.D., Applicant, Depart. of Clinic of Faculty Surgery named after N.N. Burdenko</p>ava23@mail.ruhttps://orcid.org/0000-0002-7606-1323KhalilovIldar G.<p>M.D., Cand. Sci. (Med.), Assist., Depart. of Cardiovascular and Endovascular Surgery; Head of Depart., Depart. of Vascular Surgery</p>ilhalil@mail.ruhttps://orcid.org/0000-0002-2542-2213KomarovRoman N.<p>M.D., D. Sci. (Med.), Head of Depart., Depart. of Clinic of Faculty Surgery named after N.N. Burdenko</p>Komarovroman@rambler.ruhttps://orcid.org/0000-0002-3904-6415KhalilovIskander I.<p>M.D., Clinical Resident, Depart. of Cardiovascular and Endovascular Surgery</p>iskan.halilov@gmail.comhttps://orcid.org/0000-0003-3123-8671City Clinical Hospital No. 7First Moscow State Medical University named after I.M. SechenovKazan State Medical University021220221036101310180802202201092022Copyright © 2022, Eco-Vector2022<p>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.</p>floating thrombuspost-thrombophlebitic diseaseiliofemoral thrombosisфлотирующий тромбпосттромбофлебитическая болезньилиофеморальный тромбоз[Kahn SR, Galanaud JP, Vedantham S, Ginsberg JS. Guidance for the prevention and treatment of the post-thrombotic syndrome. J Thromb Thrombolysis. 2016;41(1):144–153. DOI: 10.1007/s11239-015-1312-5.][Goldwater SZ, Bounameaux H. Pulmonary embolism and deep vein thrombosis. Lancet. 2012;379(9828):1835–1846. DOI: 10.1016/S0140-6736(11)61904-1.][Bernstein LL. Pulmonary embolism: diagnosis, antithrombotic therapy and prevention. Effektivnaya farmakoterapiya. 2013;(43):34–44. (In Russ.)][Ramaswamy RS, Akinwande O, Giardina JD, Kavali PK, Marks CG. Acute lower extremity deep venous thrombosis: The data, where we are, and how it is done. Tech Vasc Interv Radiol. 2018;21(2):105–112. DOI: 10.1053/j.tvir.2018.03.006.][Ochoa Chaar CI, Aurshina A. Endovascular and open surgery for deep vein thrombosis. Clin Chest Med. 2018;39(3):631–644. DOI: 10.1016/j.ccm.2018.04.014.][Khalilov IG. Trans"yugulyarnaya antegradnaya venoznaya trombektomiya iz iliokaval'nogo i bedrennogo segmentov s ispol'zovaniem ustroystva dlya udaleniya sgustkov krovi i inorodnykh tel iz sosudov i polykh organov — tromboekstraktora (TREKS). (Transjugular antegrade venous thrombectomy from the caval and femoral segments using a device for removing blood clots and foreign bodies from vessels and hollow organs — a thromboextractor (TREX).) Patent for invention RF No. 2743271. MPK: A61B17/00 A61B17/22 issued at 16.02.2021. (In Russ.)][Raju S, Tackett PJr, Neglen P. Reinterventions for nonocclusive iliofemoral venous stent malfunctions. J Vasc Surg. 2009;49(2):511я-518. DOI: 10.1016/j.jvs.2008.08.003.][Bokerija LA, Zatevakhin II, Kirienko AI. Rossiyskie klinicheskie rekomendatsii po diagnostike, lecheniyu i profilaktike venoznykh tromboembolicheskikh oslozhneniy (VTJeO). (Russian clinical guidelines for the diagnosis, treatment and prevention of venous thromboembolic complications (VTEC).) Flebologiya. 2015;9(4–2):1–52. (In Russ.)][Kirienko AI, Andriyashkin VV, Leont’ev SG, Mironov AV. Pulmonary embolism. In: Kardiologiya. Natsional’noe rukovodstvo. (Cardiology. National guidelines.) Moscow: GEOTAR-Media; 2015. р. 712–722. (In Russ.)][Robbins IM, Pugh ME, Hemnes AR. Update on chronic thromboembolic pulmonary hypertension. Trends Cardiovasc Med. 2017;27(1):29–37. DOI: 10.1016/j.tcm.2016.05.010.][Clements W. Inferior vena cava filters in the asymptomatic chronically occluded cava: To remove or not remove? Cardiovasc Intervent Radiol. 2019;42(2):165–168. DOI: 10.1007/s00270-018-2077-y.][Imberti D, Ageno W, Manfredini R, Fabbian F, Salmi R, Duce R, Gallerani M. Interventional treatment of venous thromboembolism: a review. Thromb Res. 2012;129(4):418–425. DOI: 10.1016/j.thromres.2011.11.003.][Belov JuV. Rukovodstvo po sosudistoy khirurgii s atlasom operativnoy tekhniki. 2-e izdanie. (Guide to vascular surgery with an atlas of operative techniques. 2nd edition.) M.: Meditsinskoe informatsionnoe agentstvo; 2011. 441 p. (In Russ.)][Mühlberger D, Wenkel M, Papapostolou G, Mumme A, Stücker M, Reich-Schupke S, Hummel T. Surgical thrombectomy for iliofemoral deep vein thrombosis: Patient outcomes at 8.5 years. PLoS One. 2020;15(6):e0235003. DOI: 10.1371/journal.pone.0235003.][Kungurtsev VV, Saraniuk RI, Kungurtsev EV, Chernov AA, Zvereva LS, Ianus VM. Thrombectomy for acute iliofemoral thrombosis in prevention of pulmonary embolism. Angiologiya i sosudistaya khirurgiya. 2019;25(4):181–187. (In Russ.) DOI: 10.33529/ANGIO2019422.]