Silaev A A, Epifanov S Iu, Shcherbatiuk K V, Kolomeĭchenko N A, Dvorianchikova V A, Avrusina E K
Clinical Hospital of the Presidential Administration of the Russian Federation, Moscow, Russia.
Angiol Sosud Khir. 2020;26(4):63-69. doi: 10.33529/ANGIO2020420.
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.
本文描述了一例关于成功手术治疗一名患有下腔静脉完全漂浮血栓和右心房血栓并伴有肺栓塞的女性患者的临床病例报告。我们的患者是一名42岁女性，表现出髂股血栓形成的临床症状。检查发现下腔静脉漂浮血栓、右心房血栓和大面积肺栓塞。鉴于存在全身溶栓的绝对禁忌症，决定采用杂交手术方法进行手术治疗。该女性在人工血液循环条件下成功地从右心房腔和肺动脉分支进行了直接血栓切除术，同时借助“Track”系统从下腔静脉清除了漂浮血栓，并放置了腔静脉滤器。本文还介绍了在治疗这种疾病方面所获得的世界经验，并论证了采用杂交方法以实现最佳临床结果的依据。
