ULTRASOUND THROMBOELASTAGRAPHY FOR THE CHOICE OF TREATMENT OF PATIENTS WITH POSTOPERATIVE VENOUS THROMBOSIS
Background. The frequency of venous thromboembolic complications in surgery practice is rather high. In many cases, it is the cause of a fatal pulmonary embolism. One of the actual tasks of ultrasonic diagnostics of acute venous thrombosis is the visual assessment of the substrate of the disease because it determines angiosurgical tactics and surgical prophylaxis of pulmonary embolism.
The objective was to prevent the development of pulmonary embolism in patients with postoperative venous thrombosis of the inferior vena cava system.
Methods. Vena cava system investigation and the determination of the sonoelastographic properties of the venous thrombus were carried out with the Siemens Acuson S2000 ultrasound system. The localization and prevalence of the thrombotic process were established. At the end of the topical diagnosis of a venous thrombus, the sonoelastographic properties of the thrombus were studied by determining the speed of propagation of the acoustic wave.
Results. The work is based on the results of examination and surgical treatment of 729 patients, of which 205 (28.12%) had operative interventions on the musculoskeletal system, 378 (51.85%) – on the abdominal organs, 146 (20.01%) – reconstructive surgery on the aorta and the main arteries of the lower extremities.
Conclusions. Embolodengerous thrombi are those venous thrombi of the inferior vena cava system which at ultrasonoelastography of the proximal segments of the venous thrombus are characterized by the acoustic wave propagation velocity within 2.5–2.8 m/s. The detection of embolic venous thrombosis is an indication for surgical methods prevention of pulmonary embolism.
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