Sukovatykh B S, Sereditskiy A V, Muradyan V F, Azarov A M, Sukovatykh M B, Lapinas A A, Khachatryan A R
Kursk State Medical University, Kursk, Russia.
Orel Regional Clinical Hospital, Orel, Russia.
Khirurgiia (Mosk). 2022(12):92-98. doi: 10.17116/hirurgia202212192.
To study the efficacy and safety of venous stenting and long-term anticoagulation with inhibitors of blood clotting factor XA in the treatment of total and subtotal deep vein thrombosis.
We analyzed 60 patients with total and subtotal deep vein thrombosis divided into 2 comparable groups by 30 people. Patients of the first group underwent regional catheter thrombolysis and percutaneous mechanical thrombectomy. The same endovascular treatment supplemented by venous stenting was performed in the second group. In the first group, rivaroxaban was prescribed before, during and for 6 months after surgery; apixaban was used in the second group. Complications of endovascular and anticoagulant therapy were recorded. After 12 months, control ultrasound and clinical examination of patients was performed to analyze recanalization of deep veins and severity of venous outflow disorders. Recanalization of veins was evaluated as follows: less than 50% - minimal, 50-99% - partial, 100% - complete.
In the first group, complete and partial recanalization of veins was found in 63.3 and 36.7% of patients, respectively. In the second group, these values were 93.3 and 6.7%, respectively. In the first group, venous outflow disorders were absent in 56.7%, mild violations presented in 36.6%, moderate violations - in 6.7% of patients. In the second group, venous outflow was normal in 93.3% of patients, and mild disorders presented in 6.7% of patients. Hemorrhagic complications developed in 8 (13.3%) patients, equally in both groups.
研究静脉支架置入术联合使用凝血因子XA抑制剂进行长期抗凝治疗全下肢及次全下肢深静脉血栓形成的疗效和安全性。
我们分析了60例全下肢及次全下肢深静脉血栓形成患者，将其分为两组，每组30人，两组具有可比性。第一组患者接受局部导管溶栓和经皮机械血栓清除术。第二组患者在进行相同的血管内治疗后补充静脉支架置入术。第一组患者在手术前、手术期间及术后6个月服用利伐沙班；第二组患者使用阿哌沙班。记录血管内治疗和抗凝治疗的并发症。12个月后，对患者进行超声检查和临床检查，以分析深静脉再通情况及静脉流出障碍的严重程度。静脉再通情况评估如下：小于50%为轻度，50%-99%为部分再通，100%为完全再通。
第一组患者中，静脉完全再通和部分再通的比例分别为63.3%和36.7%。第二组患者中，这两个比例分别为93.3%和6.7%。第一组患者中，56.7%无静脉流出障碍，36.6%有轻度静脉流出障碍，6.7%有中度静脉流出障碍。第二组患者中，93.3%的患者静脉流出正常，6.7%的患者有轻度静脉流出障碍。两组均有8例（13.3%）患者出现出血并发症。
