Trombo flutuante em veia femoral

Abstract

A floating venous thrombus in the femoral vein is a type of thrombus with a high potential for pulmonary embolization. However, the most appropriate management for these cases is still controversial. Clinical treatments, using anticoagulants or fibrinolytics, open thrombectomies, or thrombectomies by means of endovascular devices have all been used, although the criteria for indication of each are not yet defined. We present 3 clinical cases of floating thrombi in femoral veins with different etiologies and discuss their respective treatments and outcomes.Keywords: venous thrombosis; thrombectomy; anticoagulants; fibrinolysis; pulmonary embolism. ResumoO trombo venoso flutuante em veia femoral é um tipo de trombo com alto potencial de embolização pulmonar. Entretanto, ainda é controversa a conduta mais apropriada nesses casos. Tratamentos clínicos com anticoagulantes ou fibrinolíticos e trombectomias abertas ou por meio de dispositivos endovasculares vêm sendo empregados ainda sem um critério de indicação bem definido. Apresentamos três casos clínicos de trombos flutuantes em veia femoral, de etiologias distintas, cujos tratamentos e respectivas evoluções serão discutidos.

Pulmonary embolism: Successful treatment of floating thrombus in SFJ after vena cava filter insertion and surgical thrombectomy

“…In more recent experience, a note of caution against the filter use arose from guidelines with 1B evidence, but no mention of floating thrombus is reported. 11 …”

“…In more recent experience, a note of caution against the filter use arose from guidelines with 1B evidence, but no mention of floating thrombus is reported. 11 Temporary filter contribute to reduce the PTE recurrence rate. It is also often considered as an adjunctive therapy in patients with recurrent embolism despite adequate anticoagulation, as well as in patients in whom an additional embolic event would be poorly tolerated (ex, those with poor cardiopulmonary reserve from massive PE underlying cardiopulmonary disease, hemodynamically unstable patients, obese patients) as in our case.…”

Saúde em foco

“…Definida pela formação de trombos dentro de veias profundas, desencadeando a obstrução parcial ou oclusão venosa, é mais comum nos membros inferiores (MMII) (BERTANHA et al, 2017). Seus principais fatores de risco são idade avançada, processos neoplásicos, procedimentos cirúrgicos, imobilização prolongada, uso de estrogênio, gravidez e distúrbios de hipercoagulabilidade hereditários ou adquiridos (ZAGO; FAUCÃO; PASQUINI, 2014).…”