The article presents a case of treatment proximal deep venous thrombosis using different endovascular approaches. The case emphasizes the importance of individualized approach, monitoring and multidisciplinary management of patients undergoing invasive treatment of deep vein thrombosis (DVT). Patient of 42 years old came with complaints of swelling and bursting pain in the left lower limb lasting 7 days. Iliofemoral venous thrombosis of the left lower limb was confirmed. The patient underwent successful aspiration thrombectomy with subsequent balloon angioplasty. The patient developed re-thrombosis with thrombus extension to the inferior vena cava despite the initial satisfactory outcome of intervention. An inferior vena cava filter was inserted and catheter-directed thrombolysis was performed, which allowed to achieve a good technical result. Attempts of inferior vena cava filter removing in the clinic were unsuccessful and it was successfully excised only in 5 months in another hospital. No DVT recurrence were observed during 12 months of follow-up. The severity of post-thrombotic syndrome was 3 points according to the Villalta scale one year after the treatment. Due to timely diagnosis and comprehensive treatment we achieved stable venous recanalization with favorable long-term outcomes. This case suggests that using only mechanical methods of thrombus extraction without catheter-directed thrombolysis is possible only in case of complete removing ofthrombotic masses.
Kuperin et al. (Thu,) studied this question.
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