Is there a place for aggressive tactics in the treatment of deep vein thrombosis today? Clinical case of aspiration thrombectomy in the treatment of deep vein thrombosis

The use of aspiration thrombectomy in the treatment of venous thrombosis is a promising and effective method of surgical treatment. In floating venous thrombosis, when the risk of pulmonary embolism is increased, aspiration thrombectomy eliminates the risk of pulmonary embolism and restore patency of the affected venous segment, thus preventing the development of post-thrombotic syndrome. To date with aspiration thrombectomy are limited. In this clinical case, the patient was admitted to the clinic on the 7th day from the onset of symptoms with the clinic of iliofemoral venous thrombosis of the right lower extremity. Duplex scanning revealed a floating thrombus 8 cm long in the right iliofemoral venous segment. Given the ineffectiveness of conservative therapy and the preservation of flotation, the patient underwent aspiration thrombectomy from the right iliofemoral venous segment using an Aspirex catheter and a Capturex device. Due to the procedure it was possible to remove the floating thrombus and restore complete patency of the right iliofemoral venous segment. The use of the device Capturex prevented intraoperative migration of thrombotic masses into the pulmonary artery. The use of aspiration thrombectomy in floating venous thrombus of the proximal localization - iliofemoral venous segment, is a promising and effective method of restoring patency of the affected venous segment, prevention of post-thrombotic syndrome and pulmonary embolism. Given the technical features of rotational thrombectomy with an Aspirex catheter, it is advisable to use methods of intraoperative prevention of pulmonary embolism (the use of the device Capturex). The first result is encouraging, but further research is needed to study the effectiveness of aspiration thrombectomy in the treatment of deep vein thrombosis.