[Antithrombotic prophylaxis after surgical interventions on the major veins]

Area of Science:

• Vascular Surgery
• Hematology
• Thrombosis Management

Background:

• Acute thrombosis in the vena cavae superior and inferior poses significant clinical challenges.
• Effective antithrombotic prophylaxis is crucial for preventing rethrombosis and managing complications post-surgery.
• Existing prophylactic methods require evaluation for efficacy and safety.

Purpose of the Study:

• To generalize an eight-year experience with antithrombotic prophylaxis in patients with vena cava thrombosis.
• To establish the main principle of antithrombotic prophylaxis, emphasizing simultaneous correction of hemostatic disorders.
• To evaluate the efficacy and safety of a continuous regional infusion method compared to traditional approaches.

Main Methods:

• Review of an eight-year experience in 93 patients undergoing surgery for acute vena cava thrombosis.
• Application of author-elaborated methods for antithrombotic prophylaxis.
• Comparison of continuous regional infusion of rheopolyglucin-heparin mixture with nicotinic acid and Trental against general fractional heparinization.

Main Results:

• Efficacy of prophylaxis is linked to hemodynamic status in the affected extremity.
• General fractional heparinization demonstrated low efficacy and high hemorrhagic complication rates.
• Continuous regional infusion effectively corrected thrombotic hemostasis and prevented rethrombosis with minimal bleeding.

Conclusions:

• The core principle of antithrombotic prophylaxis involves simultaneous correction of coagulation, fibrinolysis, and platelet aggregation disorders.
• Continuous regional infusion of rheopolyglucin-heparin, nicotinic acid, and Trental is a safe and effective method for preventing rethrombosis in major veins.
• This approach offers superior outcomes compared to general fractional heparinization for vena cava thrombosis management.