milmedВоенная медицинаMilitary Medicine2074-5044Белорусский государственный медицинский университетmilmed-526Research ArticleОРИГИНАЛЬНЫЕ НАУЧНЫЕ ПУБЛИКАЦИИ. Новые технологии в медицинеORIGINAL SCIENTIFIC PUBLICATIONS. New technologies in medicineРезультаты применения локального катетерного тромболизиса у пациентов с илиофеморальным флеботромбозомThe results of application of regional catheter thrombolysis in patients with iliofemoral deep vein thrombosisХрыщановичВ. Я.KhryshchanovichV. Y.

г. Минск

КлимчукИ. П.KlimchukI. P.

г. Минск

КалининС. С.KalininS. S.

г. Минск

ТурлюкД. В.TurlyukD. V.

г. Минск

РоговойН. А.RogovoyN. A.

г. Минск

ГУО «Белорусская медицинская академия последипломного образования» ; УЗ «4-я городская клиническая больница им. Н.Е. Савченко»BelarusУЗ «4-я городская клиническая больница им. Н.Е. Савченко»BelarusУЗ «4-я городская клиническая больница им. Н.Е. Савченко» ; УО «Белорусский государственный медицинский университет»BelarusУЗ «4-я городская клиническая больница им. Н.Е. Савченко» ; РНПЦ «Кардиология»Belarus201820102026017782Copyright © Хрыщанович В.Я., Климчук И.П., Калинин С.С., Турлюк Д.В., Роговой Н.А., 20262026Хрыщанович В.Я., Климчук И.П., Калинин С.С., Турлюк Д.В., Роговой Н.А.Khryshchanovich V.Y., Klimchuk I.P., Kalinin S.S., Turlyuk D.V., Rogovoy N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://milmed.ejournal.by/jour/article/view/526

Исследование посвящено разработке и клинической апробации метода локального катетерного тромболизиса у пациентов с тромбозом глубоких вен. Были изучены ближайшие и отдаленные результаты применения новой эндоваскулярной технологии у 9 пациентов с флеботромбозом илиофеморальной локализации. Сравнительный анализ исходов лечения с группой пациентов, получавших монотерапию антагонистами витамина К, позволил подтвердить безопасность и высокую эффективность катетерного тромболизиса в отношении геморрагических осложнений, частоты развития посттромботической болезни и степени ее тяжести.

The aims of the study were development and clinical approbation of the method of local catheter thrombolysis in patients with deep vein thrombosis. The immediate and long-term results of the use of the new endovascular technology in nine patients with iliofemoral deep vein thrombosis were studied. Comparative analysis of treatment outcomes with a group of patients who received monotherapy with vitamin K antagonists confirmed the safety and efficacy of catheter thrombolysis in regard to hemorrhagic complications, the incidence of post-thrombotic disease and the degree of its severity.

тромбоз глубоких венкатетерный тромболизисрезультаты леченияdeep vein thrombosiscatheter thrombolysistreatment outcomesReferencesBeckman M. G., Hooper W. C., Critchley S. E. et al. Venous thromboembolism. A public health concern // Am. J. Prevent. Med. – 2010. – Vol. 38 (Suppl. 4). – P. 495–501.Beckman M. G., Hooper W. C., Critchley S. E. et al. Venous thromboembolism. A public health concern // Am. J. Prevent. Med. – 2010. – Vol. 38 (Suppl. 4). – P. 495–501.ISTH Steering Committee for World Thrombosis Day. Thrombosis: a major contributor to global disease burden // Thromb. Res. – 2014. – Vol. 134. – P. 931–938.ISTH Steering Committee for World Thrombosis Day. Thrombosis: a major contributor to global disease burden // Thromb. Res. – 2014. – Vol. 134. – P. 931–938.Cohen, A.T., Hamilton M., Mitchelletal S. A. Comparison of the novel oral anticoagulants apixaban, dabigatran, edoxaban, and rivaroxaban in the initial and long-term treatment and prevention of venous thromboembolism: systematic review and network meta-analysis // PLoS 1. – 2015. – Vol. 10 (12). – ID e0144856.Cohen, A.T., Hamilton M., Mitchelletal S. A. Comparison of the novel oral anticoagulants apixaban, dabigatran, edoxaban, and rivaroxaban in the initial and long-term treatment and prevention of venous thromboembolism: systematic review and network meta-analysis // PLoS 1. – 2015. – Vol. 10 (12). – ID e0144856.Mahan C. E., Barco S., Spyropoulos A. C. Cost-of-illness model for venous thromboembolism // Thromb. Res. – 2016. – Vol. 145. – P. 130–132.Mahan C. E., Barco S., Spyropoulos A. C. Cost-of-illness model for venous thromboembolism // Thromb. Res. – 2016. – Vol. 145. – P. 130–132.Kearon C. Natural history of venous thromboembolism // Circulation. – 2003. – Vol. 107. – P. 22–30.Kearon C. Natural history of venous thromboembolism // Circulation. – 2003. – Vol. 107. – P. 22–30.Heit J. A. Epidemiology of venous thromboembolism // Nat. Rev. Cardiol. – 2015. – Vol. 12. – P. 464–474.Heit J. A. Epidemiology of venous thromboembolism // Nat. Rev. Cardiol. – 2015. – Vol. 12. – P. 464–474.Akesson H., Brudin L., Dahlstrom J. A. et al. Venous function assessed during a 5-year period after acute iliofemoral venous thrombosis treated with anticoagulation // Eur. J. Vasc. Surg. – 1990. – Vol. 4. – P. 43–48.Akesson H., Brudin L., Dahlstrom J. A. et al. Venous function assessed during a 5-year period after acute iliofemoral venous thrombosis treated with anticoagulation // Eur. J. Vasc. Surg. – 1990. – Vol. 4. – P. 43–48.Stain M., Schonauer V., Minar E. et al. The post-thrombotic syndrome: risk factors and impact on the course of thrombotic disease // J. Thromb. Haemost. – 2005. – Vol. 3. – P. 2671–2676.Stain M., Schonauer V., Minar E. et al. The post-thrombotic syndrome: risk factors and impact on the course of thrombotic disease // J. Thromb. Haemost. – 2005. – Vol. 3. – P. 2671–2676.Enden T., Kløw N. E., Sandvik L. et al. Catheter-directed thrombolysis vs. anticoagulant therapy alone in deep vein thrombosis: results of an open randomized, controlled trial reporting on short-term patency // J. Thromb. Haemost. – 2010. – Vol. 7. – P. 1268–1275.Enden T., Kløw N. E., Sandvik L. et al. Catheter-directed thrombolysis vs. anticoagulant therapy alone in deep vein thrombosis: results of an open randomized, controlled trial reporting on short-term patency // J. Thromb. Haemost. – 2010. – Vol. 7. – P. 1268–1275.Prandoni P., Lensing A.W., Cogo A. et al. The long-term clinical course of acute deep venous thrombosis // Ann. Intern. Med. – 1997. – Vol. 125. – P. 1–7.Prandoni P., Lensing A.W., Cogo A. et al. The long-term clinical course of acute deep venous thrombosis // Ann. Intern. Med. – 1997. – Vol. 125. – P. 1–7.Stain M., Schonauer V., Minar E. et al. The postthrombotic syndrome: risk factors and impact on the course of thrombotic disease // J. Thromb. Haemost. – 2005. – Vol. 3. – P. 2671–2676.Stain M., Schonauer V., Minar E. et al. The postthrombotic syndrome: risk factors and impact on the course of thrombotic disease // J. Thromb. Haemost. – 2005. – Vol. 3. – P. 2671–2676.Schulman S., Lindmarker P., Holmstroom M. et al. Post-thrombotic syndrome, recurrence, and death 10 years after the first episode of venous thromboembolismtreated with warfarin for 6 weeks or 6 months // J. Thromb. Haemost. – 2006. – Vol. 3. – P. 734–742.Schulman S., Lindmarker P., Holmstroom M. et al. Post-thrombotic syndrome, recurrence, and death 10 years after the first episode of venous thromboembolismtreated with warfarin for 6 weeks or 6 months // J. Thromb. Haemost. – 2006. – Vol. 3. – P. 734–742.Kearon C., Akl E. A., Comerota A. J. et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed.: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines // Chest. – 2012. – Suppl. 141. – P. 419–940.Kearon C., Akl E. A., Comerota A. J. et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed.: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines // Chest. – 2012. – Suppl. 141. – P. 419–940.Meissner M. H., Gloviczki P., Comerota A. J. et al. Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum // J. Vasc. Surg. – 2012. – Vol. 55. – P. 1449–1462.Meissner M. H., Gloviczki P., Comerota A. J. et al. Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum // J. Vasc. Surg. – 2012. – Vol. 55. – P. 1449–1462.Vedantham S., Millward S. F., Cardella J. F. et al. Society of Interventional Radiology position statement: treatment of acute iliofemoral deep vein thrombosis with use of adjunctive catheter-directed intrathrombus thrombolysis // J. Vasc. Interv. Radiol. – 2010. – Vol. 20. – P. 332–335.Vedantham S., Millward S. F., Cardella J. F. et al. Society of Interventional Radiology position statement: treatment of acute iliofemoral deep vein thrombosis with use of adjunctive catheter-directed intrathrombus thrombolysis // J. Vasc. Interv. Radiol. – 2010. – Vol. 20. – P. 332–335.Vedantham S., Grassi C. J., Ferral H. et al. Technology Assessment Committee of the Society of Interventional Radiology Reporting standards for endovascular treatment of lower extremity deep vein thrombosis // J. Vasc. Interv. Radiol. – 2009. – Vol. 20. – P. 391–408.Vedantham S., Grassi C. J., Ferral H. et al. Technology Assessment Committee of the Society of Interventional Radiology Reporting standards for endovascular treatment of lower extremity deep vein thrombosis // J. Vasc. Interv. Radiol. – 2009. – Vol. 20. – P. 391–408.Haig Y., Enden T., Slagsvold C. E. et al. Determinants of early and long-term efficacy of catheter-directed thrombolysis in proximal deep vein thrombosis // J. Vasc. Interv. Radiol. – 2013. – Vol. 24. – P. 17–24.Haig Y., Enden T., Slagsvold C. E. et al. Determinants of early and long-term efficacy of catheter-directed thrombolysis in proximal deep vein thrombosis // J. Vasc. Interv. Radiol. – 2013. – Vol. 24. – P. 17–24.Sharafuddin M. J., Sun S., Hoballah J. J. et al. Endovascular management of venous thrombotic and occlusive diseases of the lower extremities // J. Vasc. Interv. Radiol. – 2003. – Vol. 14. – P. 405–423.Sharafuddin M. J., Sun S., Hoballah J. J. et al. Endovascular management of venous thrombotic and occlusive diseases of the lower extremities // J. Vasc. Interv. Radiol. – 2003. – Vol. 14. – P. 405–423.Enden T., Sandvik L., Kløw N. E. et al. Catheter-directed Venous Thrombolysis in acute iliofemoral vein thrombosis – the CaVenT study: Rationale and design of a multicenter, randomized, controlled clinical trial (NCT00251771) // Am. Heart J. – 2007. – Vol. 154. – P. 808–814.Enden T., Sandvik L., Kløw N. E. et al. Catheter-directed Venous Thrombolysis in acute iliofemoral vein thrombosis – the CaVenT study: Rationale and design of a multicenter, randomized, controlled clinical trial (NCT00251771) // Am. Heart J. – 2007. – Vol. 154. – P. 808–814.Enden T., Haig Y., Klow N.E. et al. CaVenT Study Group. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): A randomised controlled trial // Lancet. – 2012. – Vol. 379. – P. 31–38.Enden T., Haig Y., Klow N.E. et al. CaVenT Study Group. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): A randomised controlled trial // Lancet. – 2012. – Vol. 379. – P. 31–38.Gombert A., Gombert R., Barbati M.E. Patency rate and quality of life after ultrasound-accelerated catheter-directed thrombolysis for deep vein thrombosis // Phlebology. – 2017. – DOI: 10.1177/0268355517697784.Gombert A., Gombert R., Barbati M.E. Patency rate and quality of life after ultrasound-accelerated catheter-directed thrombolysis for deep vein thrombosis // Phlebology. – 2017. – DOI: 10.1177/0268355517697784.Bækgaard N., Klitfod L., Jørgensen M. should catheterdirected thrombolysis be monitored? // Phlebology. – 2016. – Vol. 31. – P. 5–10.Bækgaard N., Klitfod L., Jørgensen M. should catheterdirected thrombolysis be monitored? // Phlebology. – 2016. – Vol. 31. – P. 5–10.Lu T., Loh T. M., El-Sayed H.F. et al. Single-center retrospective review of ultrasound-accelerated versus traditional catheter-directed thrombolysis for acute lower extremity deep venous thrombosis // Vascular. – 2017. – Vol. 25 (5). – P. 525–532.Lu T., Loh T. M., El-Sayed H.F. et al. Single-center retrospective review of ultrasound-accelerated versus traditional catheter-directed thrombolysis for acute lower extremity deep venous thrombosis // Vascular. – 2017. – Vol. 25 (5). – P. 525–532.Lin M., Hsieh J. C. F., Hanif M. et al. Evaluation of thrombolysis using tissue plasminogen activator in lower extremity deep venous thrombosis with concomitant femoral-popliteal venous segment involvement // J. Vasc. Surg. Ven. Lymph. Disord. – 2017. – Vol. 5 (5). – P. 613–620.Lin M., Hsieh J. C. F., Hanif M. et al. Evaluation of thrombolysis using tissue plasminogen activator in lower extremity deep venous thrombosis with concomitant femoral-popliteal venous segment involvement // J. Vasc. Surg. Ven. Lymph. Disord. – 2017. – Vol. 5 (5). – P. 613–620.Behravesh S., Hoang P., Nanda A. et al. Pathogenesis of thromboembolism and endovascular management // Thrombosis. – 2017. – DOI: 10.1155/2017/3039713.Behravesh S., Hoang P., Nanda A. et al. Pathogenesis of thromboembolism and endovascular management // Thrombosis. – 2017. – DOI: 10.1155/2017/3039713.Wells P., Anderson D. The diagnosis and treatment of venous thromboembolism // Hematology. – 2013. – Vol. 13. – P. 457–463.Wells P., Anderson D. The diagnosis and treatment of venous thromboembolism // Hematology. – 2013. – Vol. 13. – P. 457–463.Villalta S., Bagella P., Piccioloi A. et al. Assessment of validity and reproducibility of a clinical scale for the post-thrombotic syndrome // Haemostasis. – 1994. – Vol. 24. – P. 158a.Villalta S., Bagella P., Piccioloi A. et al. Assessment of validity and reproducibility of a clinical scale for the post-thrombotic syndrome // Haemostasis. – 1994. – Vol. 24. – P. 158a.Comerota A. J. Treatment of acute iliofemoral deep venous thrombosis: a strategy of thrombus removal // Eur. J. Vasc. Endovasc. Surg. – 2007. – Vol. 3. – P. 351–360.Comerota A. J. Treatment of acute iliofemoral deep venous thrombosis: a strategy of thrombus removal // Eur. J. Vasc. Endovasc. Surg. – 2007. – Vol. 3. – P. 351–360.

The authors declare that there are no conflicts of interest present.