Тромбоэмболия лёгочной артерии при остром варикотромбофлебите нижних конечностей

Abstract

Background: The purpose of the study is the improvement of treatment results in the patients with superficial vein thrombosis, associated with varicose veins (SVT-AVV) of lower limbs, through studying the frequency of pulmonary embolism (PE) cases and the factors predisposing to it. Material and methods: 236 patients with SVT-AVV have been examined and the disease has been observed in 250 lower limbs. A triplex scanning of the venous system of both lower limbs with the registration of all embolic areas of superficial and deep veins has been carried out in every patient. PE clinic picture has been confirmed by computer angiopulmonography. Results: The results of the study have showed that SVT-AVV is complicated by clinically distinct PE in 3.8% of cases (95% CI 1.8-7.1). The frequency of PE among the persons with SVT-AVV without a thrombotic process in deep venous system has amounted to 1.1% and when this process was present – to 14.6% (р < 0,001). PE has been registered more frequently in the patients with the thrombotic process in both lower limbs (p = 0.004). In the patients with SVT-AVV the frequency of PE has been significantly increasing along with the increase of the number of its possible sources (p = 0.007). The frequency of PE at SVT-AVV presence with the top clots localization in the small saphenous vein has not differed significantly from the same indicator of the great saphenous vein, indicating to the frequent underestimation of the role of this vein. Conclusions: The survey of the patients with SVT-AVV should be directed to the thorough identification of all possible sources of PE, considering a special risk of its development in the persons with thrombotic process in both lower limbs and concomitant deep venous thrombosis.