Komplexní řešení ileofemorální trombózyna konci těhotenství provedením císařskéhořezu v kombinaci s trombektomií

Overview

Acute deep ileofemoral thrombosis was treated at the end of pregnancy in four preg-nant women. A multidisciplinary approach was selected. During a single anaesthesia the team ofobstetricians and neonatologists made a Caesarean section followed by thrombectomy with a Fo-garty catheter. This operation was performed by a team of specialists in cardiovascular surgery.Two women developed rethrombosis: one woman on the following day, the second one two weeksafter surgery. In both instances repeated thrombectomy was performed. In one woman the causeof ileofemoral thrombosis was malignant disease of the uterine cervix II° and this woman is, afteroncological treatment, in a serious condition due to the basis disease. The remaining three wo-men were repeatedly subjected to phlebographic examinations and complete patency of the deepvascular system was found. These women are free from subjective and objective complaints andcan look after their children. Pregnant women where a serious ileofemoral thrombosis was diagnosed had high fibrinogen and thrombocyte levels. In two women an AT III deficiency wasfound. There was also a high cholesterol level and positive antiphospholipid antibodies. Throm-bectomy has according to the authors’ experience very good results when the operation is imple-mented within 72 hours after initial symptoms. This procedure reduces the risk of chronic venousinsufficiency.

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