Abstract:

Aim. Was to define prognostically meaningful ultrasound criteria for embologenic thrombus.

Materials and methods. 780 patients (800 limbs) with acute venous thrombosis were investigated; first group consisted of 370 patients with pulmonary embolism (PE) confirmed by lungs perfusion scintigraphic study; second group included 410 patients without PE. During ultrasound examination - 545 patients with floating thrombus were detected: 302 patients with PE (1st group) and 243 without PE (2nd group).

Results. In the first group (with PE) floating thrombus were detected in 79,5% of patients, in 20,5% of patients occlusive and nonocclusive thrombus were detected. It turned out that embologenic thrombus were localized more in shin veins (87,5%), popliteal vein (87,5%) and femoral vein (55,7%). Free floating thrombus had a form of elliptic paraboloid (60,1%), irregular form (67,9%), unechogenic structure with unechogenic contour (44,0%) or heterogenic structure with unechogenic contour (33,8%), high mobility (66,5%) (p>0,05). The length of thrombus was the same in both subgroups (p>0,05).

Conclusions. Floating trombus in 55,4% are embologenic, and are often localized in shin veins, popliteal vein and femoral vein. The absence of a floating pieces after PE indicates that occurred fragmentation of thrombus. It is found that embologenic thrombus often have a form of elliptic paraboloid. The length of thrombus can not be used as single criterion for thrombus's embologenic.  

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Abstract:

Article presents the first successful experience of thrombolytic therapy in a patient with severe burns, complicated by pulmonary embolism. Article describes detailed analysis of tactics of treatment, with the help of foreign and domestic recommendtions. Analysis shows that in patient with burns in case of pulmonary embolism, thrombolytic therapy is a method of choice. 

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