Surgical aspects of treatment of total varicothrombophlebitis of the great subcutaneous vein
DOI:
https://doi.org/10.11603/2414-4533.2021.1.11902Keywords:
total varicothrombophlebitis, great saphenous vein, scleroobliteration, phlebocentesis, crossectomyAbstract
The aim of the work: to justify the indications for surgical treatment of total varicothrombophlebitis in the basin of the great saphenous vein.
Materials and Methods. The analysis of the results of examination and treatment of 27 patients with total varicothrombophlebitis in the basin of the great saphenous vein is presented.
Results and Discussion. In 24 (88.9 %) patients, the apex of thrombotic masses was localized in the upper third of the thigh by an average of (5.2±1.4) cm from the saphenofemoral cotyledon. In 3 (11.1 %) patients, the apex of thrombotic masses reached the ostial valve, but did not pass through the saphenofemoral cotyledon. The lower limit of thrombotic lesions in 4 (14.8 %) patients was localized in the upper, in 16 (59.3 %) – in the middle and in 7 (25.9 %) – in the lower thirds of the leg. In 22 (81.5 %) patients, in addition to the main trunk, the tributaries of VTP were involved in the pathological process. Varicose veins were observed in 21 (95.5 %) patients with thrombotic lesions.
Surgery necessarily included a crossectomy, removal of the thrombosed trunk of the VTP and, if necessary, thrombosed inflows, subfascial ligation of failed veins. In the absence of varicose veins and failed penetrating veins, the volume of surgery was reduced by phlebocentesis followed by scleroobliteration. Active surgical tactics for total varicothrombophlebitis have effectively prevented the development of venous thromboembolic complications.
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