Thrombosis of Saphenofemoral and Saphenopopliteal Junction
Introduction. Until recently in the native literature saphenofemoral and saphenopopliteal junctions were considered as junctions of great saphenous vein of the common femoral vein and small saphenous veins of the popliteal vein. Today the meaning of these terms has changed cardinally.
Objective: to improve the results of treatment of patients with superficial vein thrombosis associated with varicose veins of lower limbs by studying the peculiarities of this nosological unit attached to thrombosis saphenofemoral and saphenopopliteal junction in modern sense.
Material and methods. 236 patients with superficial vein thrombosis associated with varicose veins of the lower limbs were examined. In 14 patients (5.9 %) it was observed superficial vein thrombosis associated with varicose veins on 2 lower limbs. All the patients before treatment were carried out to ultrasound scan tripleks of venous system of the affected thrombotic process and contralateral lower limbs with a detailed mapping of all pathological venous reflux and dissemination parcels thrombotic process.
Results, discussion and сonclusions. We found that the thrombosis of saphenofemoral and/or saphenopopliteal junction were found in 27.6% (95% CI 22.2–33.6 %) of lower limbs with superficial vein thrombosis associated with varicose veins. The tendency to more frequent manifestation of thrombosis saphenofemoral junction (17.2 %; 95% CI 12.7–22.5 %), than thrombosis saphenopopliteal junction (11.2 %; 95% CI 7.6–15.8 %) (p = 0.065) was discovered among the total number of lower limbs with superficial vein thrombosis associated with varicose veins detection, but among the limbs of pathological reflux in the correspondent vein, and among the limbs with thrombosis of respective vein the saphenofemoral junction thrombosis was discovered statistically significantly rarely than the saphenopopliteal junction thrombosis (in both cases p < 0.001). This suggests that the distribution probability of thrombus to saphenopopliteal junction is greater on small saphenous veins thrombosis than in great saphenous veins thrombosis presence - by saphenofemoral junction. It was determined that the level of valve terminal of great and small saphenous veins is such level at which the progressive thrombotic process is delayed in the majority of patients. We researched that among the limbs localized thrombotic process in the saphenofemoral or saphenopopliteal junction the concomitant deep venous thrombosis was discovered more often statistically significant (p < 0.001) than in the limbs without thrombosis saphenofemoral or saphenopopliteal junction: 24.6 % (95% CI 15.1–36.5 %) versus 6.1 % (95% CI 3.1–10.6 %). Also it was shown that pulmonary embolism occurs more often statistically significant (p < 0.001) in patients with thrombosis of the saphenofemoral or saphenopopliteal junction, than in patients without such thrombosis: 11.9 % (95% CI 5.3–22.2 %) versus 0.6 % (95% CI 0.0–3.3 %).
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