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The new era in the treatment of deep vein occlusion

100%

Kęsik J. J. , Terlecki P. , Feldo M. , Pietura R. , Zubilewicz T.

Polish Journal of Public Health

2015

tom 125

nr 1

36-38

A non-invasive, conservative treatment has been a standard in treating acute and chronic deep vein thrombosis. This treatment turned out to be ineffective, particularly in the hip area. Also, it was demonstrated that it does not influence the frequency of manifestations of post-thrombotic syndrome. Previous attempts to surgically reconstruct deep veins, unlike arteries reconstruction, yielded no positive results and also increased hemorrhagic and embolic complications. Currently, already in the period of the acute thrombosis of deep veins, the methods of early re-canalization, both with the application of targeted thrombolisis, as well as of pharmacomechanical methods, are applied. Thanks to a wide array of image examination methods applied in pre-operational and intra-operational diagnostics optimum, it is possible to plan a revascularising treatment in the sick individuals suffering from the already developed manifestations of the post-thrombotic syndrome. The development of endovascular methods, made possible thanks both to the surgeons’ experience in the re-canalization field, as well as constant improvements of stents dedicated to the venous system, allowed for effective use of these techniques in curing the occlusion of deep veins. It was the case with the arterial system and works here as well. Applying the hybrid proceeding, combining opened techniques and endovascular ones, works very well in selected cases.

Percutaneous retrieval of a fractured portacath fragment in two patients undergoing long-term chemotherapy

72%

Norwa J. , Darocha S. , Dobosiewicz A. , Koteja A. , Pietrasik A. , Pietura R. , Torbicki A. , Szmit S. , Kurzyna M.

OncoReview

2016

tom 6

nr 2

A57-61

The paper discusses two clinical cases of cancer patients undergoing chemotherapy, in whom fractured and displaced tips of portacath catheters were revealed based on plain chest imaging. In the first case, the portacath fragment migrated to the left pulmonary artery, with the missing catheter tip revealed during the procedure of port removal due to its occlusion, with no other prior clinical symptoms. In the second case, the catheter broke off at the level of its entry into the subclavian vein, and migrated into the right cardiac ventricle, which was accompanied by mild pain and oedema in the subclavicular region. Both patients underwent successful procedures of percutaneous foreign body retrieval with the use of endovascular snares. The procedures were performed via femoral vein access, with no complications.