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Review
. 2020;26(4):63-69.
doi: 10.33529/ANGIO2020420.

[Hybrid treatment of total thrombosis of the inferior vena cava]

[Article in Russian]
A A Silaev  1 , S Iu Epifanov  1 , K V Shcherbatiuk  1 , N A Kolomeĭchenko  1 , V A Dvorianchikova  1 , E K Avrusina  1
Affiliations
Review

[Hybrid treatment of total thrombosis of the inferior vena cava]

[Article in Russian]
A A Silaev et al. Angiol Sosud Khir. 2020.

Abstract
in English, Russian

Described in the article is a clinical case report regarding successful surgical treatment of a female patient with total floating thrombosis of the inferior vena cava and thrombosis of the right atrium, complicated by pulmonary embolism. Our patient was a 42-year-old woman presenting with a clinical pattern of iliofemoral thrombosis. The examination revealed floating thrombosis of the inferior venal cava, right atrial thrombosis, and massive pulmonary embolism. Given the presence of absolute contraindications to systemic thrombolysis, it was decided to carry out surgical treatment by means of a hybrid-operation procedure. The woman underwent successful direct thrombectomy from the right-atrium cavity and branches of the pulmonary artery in conditions of artificial blood circulation, simultaneously accompanied by removing the floating thrombus from the inferior vena cava with the help of the 'Track' system, as well as by placement of a cava filter. Also presented herein is a review of the world experience gained in treating this pathology, followed by substantiation of using a hybrid approach for achieving an optimal clinical outcome.

В статье представлен клинический случай успешного хирургического лечения пациентки с тотальным флотирующим тромбозом нижней полой вены, тромбозом правого предсердия, осложненного массивной тромбоэмболией легочной артерии. Пациентка, 42 лет, с клинической картиной илиофеморального тромбоза. При обследовании выявлен флотирующий тромбоз нижней полой вены, тромбоз правого предсердия, массивная тромбоэмболия легочной артерии. С учетом наличия абсолютных противопоказаний к системному тромболизису выполнено хирургическое лечение гибридной операционной. Пациентке успешно проведена прямая тромбэктомия из полости правого предсердия и ветвей легочной артерии в условиях искусственного кровообращения, с одновременным удалением флотирующего тромба из нижней полой вены системой 'Трэк' и установкой кава-фильтра. Приведен обзор мирового опыта лечения данной патологии. Обосновано применение гибридного подхода для достижения оптимального клинического результата.

Keywords: hybrid operations; inferior vena cava thrombosis; left atrial thrombosis; pulmonary embolism.

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