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:

In order to check the efficiency of pharmacological prophylaxis of venous thromboembolism in 500 patients with multiple injuries we weekly performed ultrasonography of lower limb veins from 3-5 days after the accident date. Patients were divided into two groups. There were 186 patients with prophylaxis with LMWH in the first group, other group included 314 patients which took single antiplatelet therapy. Thrombosis occured in 29 (15.6%) cases in the first group. In 19 (61.2%) limbs thrombosis defeated the common femoral vein and it was floating in 67.7% of cases. In the second group thrombosis was found in 165 (52.5%) patients. Mural (46%) and occlusive (35.3%) changes from the proximal border, not reaching the common femoral vein - (62%) were dominating.

It was found that during fraxiparine treatment venous complications were 3.3 times less likely than with antiplatelet agents, however, 3.6 times increased the proportion of floating embologenic thrombosis. However, in these patients, the spread of the pathological process in the proximal direction noted in 2 times less, and the beginning of recanalization 1-2 weeks earlier and more effective restoration of the lumen.

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Abstract:

Aim: was to evaluate possibilities of using of ultrasound classification of subcutaneous rupture of the Achilles tendon (AT) for hospital clinical practice.

Materials and methods: we examined 11 patients (9 men and 2 women). Clinical and X-ray examinations were done. Ultrasound examination was done by the standard method; modern sonographic classification of the rupture of AT was done with functional probe

Results: clinical signs of subcutaneous rupture of AT were obtained in each patient. According to sonographic classification, complete AT rupture was found in 27,2% patients (3 of 11), incomplete rupture was found in 72,8% (8 of 11). Tendinosis signs were found in 37,5% patients (3 of 8) with incomplete rupture.

Conclusions: obtained data prove the effectiveness of ultrasound method of diagnosis of subcutaneous rupture of AT, in detection various variants of its trauma. It is important for optimization of treatment strategy. 

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