Authors
Litvinov A.A., Marchak D.I., Stoyko Yu.M.
St. George thoracic and cardiovascular surgery clinic Pirogov National Medical and Surgical Center, Moscow
Abstract
A clinical observation of a 42-year-old female patient suffering from post-thrombotic syndrome and obstructive lesions of the iliocaval segment in combination with a previously implanted cava filter after a tibial fracture complicated by deep vein thrombosis of the lower extremities in 2011 is presented. Despite prolonged treatment, no positive result in the patient’s condition was achieved. The prolonged lack of effect from conservative therapy gradually led to the progression of disease severity and a decrease in the patient’s quality of life. In January 2021, bifurcational venous stenting using the “double-barrel” technique was performed at the N.I. Pirogov National Medical and Surgical Center. Follow-up examinations at 6 and 12 months confirmed stent patency with significant clinical improvement in the patient.
Keywords: post-thrombotic syndrome, cava filter, venous stenting, bifurcational stenting of the inferior vena cava.
References
1. Shevchenko JuL, Stojko JuM. Klinicheskaja flebologija. Moscow: DPK Press, 2016 (In Russ).
2. Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis. 2016; 41(1): 3-14. doi: 10.1007/s11239-015-1311-6
3. Liu Y, Lu H, Bai H, Liu Q, Chen R. Effect of inferior vena cava filters on pulmonary embolism-related mortality and major complications: a systematic review and meta-analysis of randomized controlled trials. J Vasc Surg Venous Lymphat Disord. 2021; 9(3): 792-800.e2. doi: 10.1016/j.jvsv.2021.02.008.
4. Sella DM, Oldenburg WA. Complications of inferior vena cava filters. Semin Vasc Surg. 2013; 26(1): 23-28. doi: 10.1053/j.semvascsurg.2013.04.005.
5. Litvinov AA. Sravnitel’naya harakteristika venoznyh stentov. Vestnik NMHC im. N.I. Pirogova. 2021; 16(2): 98-104. (In Russ.) doi: 10.25881/20728255_2021_16_2_98.
6. Neglén P, Darcey R, Olivier J, Raju S. Bilateral stenting at the iliocaval confluence. J Vasc Surg. 2010; 51(6): 1457-1466. doi: 10.1016/j.jvs.2010.01.056.
7. Ye K, Lu X, Li W, et al. Outcomes of Stent Placement for Chronic Occlusion of a Filter-bearing Inferior Vena Cava in Patients with Severe Post-thrombotic Syndrome. Eur J Vasc Endovasc Surg. 2016; 52(6): 839-846. doi: 10.1016/j.ejvs.2016.08.050.
8. Raju S. Treatment of iliac-caval outflow obstruction. Semin Vasc Surg. 2015; 28(1): 47-53. doi: 10.1053/j.semvascsurg.2015.07.001.
9. Neglén P, Oglesbee M, Olivier J, Raju S. Stenting of chronically obstructed inferior vena cava filters. J Vasc Surg. 2011; 54(1): 153-161. doi: 10.1016/j.jvs.2010.11.117.