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The authors performed 72 endovascular catheter thrombectomies (ECT) in patients with "high" floating thromboses of the inferior vena cava (IVC). Thrombi from the IVC were completely evacuated in 48 and from the common iliac veins - in 4 patients. Partial thrombectomy from the IVC was accomplished in 20 patients. As a result of the interventions, a number of problems were solved: the source of embolism was eliminated, the conditions were created for cava filter (CF) placement to the standard position distal to the openings of the renal veins; after complete ECT the patency of the IVC and normal laminar flow were restored. The patency of the IVC at the hospital stage was maintained in 92.9% and in the long-term period - in 83.3% of patients. The study of the short and long-term results enabled the authors to work out an algorithm of using ECT in overall prevention of pulmonary thromboembolism (PTE) and in the treatment of floating thromboses of the IVC as dependent on the patient's condition, coexistent diseases, the etiology, site, extension of thrombosis, and risk factors of rethrombosis.

This paper analyzes the results of a multimodality instrumental study of the structural and functional properties of the inferior vena cava (IVC) in 173 patients with acute venous thrombosis, who underwent different interventions aimed at pulmonary thromboembolism (PTE) prevention. Of these, 63% of patients were examined in the long-term period, within the time 2 to 36 months. 26% of patients were found to have variants of the anatomic structure of the IVC system, such as the doubling of the renal veins, ring-shaped structure or entry to the IVC at a distance exceeding 5 cm from each other. The paper also provides a detailed analysis of the hemodynamic parameters (maximal and minimal linear flow velocities in the IVC, time-averaged maximal linear flow velocities and their different indices) and of their changes as dependent on the type of interventions on the IVC. It has been established on the basis of the data obtained that endovascular catheter thrombectomy is the method for PTE prevention because it restores the IVC lumen and refines the regional hemodynamics. Cava filter implantation induces a rounded deformation and expansion of the infrarenal IVC up to 40.9% of the area of its cross section but exerts a minimal adverse effect on the flow. IVC plication leads to a slit-like deformation and a 12.9% stenosis of its lumen as well as to deceleration of the flow acquiring a turbulent character.