Embolism-Threatening Thrombosis: Is There Such a Problem?

doi:https://doi.org/10.17116/flebo20241801138

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Abstract:

The review is devoted to modern literature data on floating venous thrombosis. Historical data regarding surgical venous disconnection and recanalization are presented. The authors reviewed modern studies devoted to embolism-threatening thrombosis and appropriate international recommendations. Deep vein thrombosis (DVT) of the lower extremities and pelvis is characterized by clotting in appropriate veins. Pulmonary embolism (PE) is the main and life-threatening complication of DVT. Floating thrombosis is believed to be very dangerous for many years and absolutely requires surgical prevention of PE. Nevertheless, appropriate data are contradictory. Most professional communities recognize impossible anticoagulation as the only indication for cava filter implantation. National guidelines (2023) do not recognize proximal floating thrombus as the only indication for cava filter implantation. Unclear role of floating clots as a risk factor for PE forces specialists to continue cava filter implantation in these cases to this day. Importantly, percutaneous cava filter implantation is really not always possible. This fact requires more invasive partial and complete disconnection with higher incidence of complications, such as ligation of superficial femoral vein, plication of inferior vena cava and open thrombectomy. These features inspired us to analyze venous thrombosis as a risk factor of pulmonary embolism.

Keywords:

deep vein thrombosis

pulmonary embolism

floating thrombus

vena cava filter

Received:

21.11.2023

Accepted:

15.12.2023

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References:

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