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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">akusherstvo</journal-id><journal-title-group><journal-title xml:lang="en">Obstetrics, Gynecology and Reproduction</journal-title><trans-title-group xml:lang="ru"><trans-title>Акушерство, Гинекология и Репродукция</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2313-7347</issn><issn pub-type="epub">2500-3194</issn><publisher><publisher-name>IRBIS LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17749/2313-7347/ob.gyn.rep.2026.744</article-id><article-id custom-type="elpub" pub-id-type="custom">akusherstvo-2802</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW ARTICLES</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НАУЧНЫЕ ОБЗОРЫ</subject></subj-group></article-categories><title-group><article-title>The silent legacy of venous thromboembolism: why rehabilitation is the missing link</article-title><trans-title-group xml:lang="ru"><trans-title>Безмолвное наследие венозной тромбоэмболии: почему реабилитация является недостающим звеном</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3367-9844</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Блинов</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Blinov</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Блинов Дмитрий Владиславович, д.м.н.</p><p>Scopus Author ID: 6701744871. WoS ResearcherID: E-8906-2017</p><p>101000 Москва, Лялин переулок, д. 11–13/1</p><p>123056 Москва, 2-я Брестская ул., д. 5, с. 1–1а</p><p>Московская область, деревня Голубое, ул. Родниковая, стр. 6, к. 1</p></bio><bio xml:lang="en"><p>Dmitry V. Blinov, MD, Dr Sci Med.</p><p>Scopus Author ID: 6701744871. WoS ResearcherID: E-8906-2017</p><p>11–13/1 Lyalin Pereulok, Moscow 101000</p><p>5 bldg. 1–1a, 2-ya Brestskaya Str., Moscow 123056</p><p>6 bldg. 1, Rodnikovaya Str., Village Goluboe, Moscow region 141551</p></bio><email xlink:type="simple">blinov2010@googlemail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7456-2386</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Солопова</surname><given-names>А. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Solopova</surname><given-names>A. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Солопова Антонина Григорьевна, д.м.н., проф.</p><p>Scopus Author ID: 6505479504. WoS ResearcherID: Q-1385-2015</p><p>119048 Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Antonina G. Solopova, MD, Dr Sci Med, Prof.</p><p>Scopus Author ID: 6505479504. WoS ResearcherID: Q-1385-2015</p><p>8 bldg. 2, Trubetskaya Str., Moscow 119048</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8404-1042</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бицадзе</surname><given-names>В. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Bitsadze</surname><given-names>V. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бицадзе Виктория Омаровна, д.м.н., проф., профессор РАН</p><p>Scopus Author ID: 6506003478. WoS ResearcherID: F-8409-2017</p><p>119048 Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Victoria O. Bitsadze, MD, Dr Sci Med, Prof., Professor of RAS</p><p>Scopus Author ID: 6506003478. WoS ResearcherID: F-8409-2017</p><p>8 bldg. 2, Trubetskaya Str., Moscow 119048</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0725-9686</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хизроева</surname><given-names>Д. Х.</given-names></name><name name-style="western" xml:lang="en"><surname>Khizroeva</surname><given-names>J. Kh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хизроева Джамиля Хизриевна, д.м.н., проф.</p><p>Scopus Author ID: 57194547147. WoS ResearcherID: F-8384-2017</p><p>119048 Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Jamilya Kh. Khizroeva, MD, Dr Sci Med, Prof.</p><p>Scopus Author ID: 57194547147. 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Tretyakova, MD, PhD.</p><p>8 bldg. 2, Trubetskaya Str., Moscow 119048</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0764-4477</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гашимова</surname><given-names>Н. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Gashimova</surname><given-names>N. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гашимова Нилуфар Рамиль кызы, к.м.н.</p><p>119048 Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Nilufar R. 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Khazan, MD, PhD.</p><p>Scopus Author ID: 16836608700</p><p>51 bldg. 1, 3-ya Parkovaya Str., Moscow 105425</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мнацаканьян</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Mnatsakanyan</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мнацаканьян Анна Никитична, к.ф.н.</p><p>105005 Москва, ул. 2-я Бауманская, д. 5, стр. 1</p></bio><bio xml:lang="en"><p>Anna N. Mnatsakanyan, MD, PhD in Philology</p><p>5 bldg 1, 2-ya Baumanskaya Str., Moscow 105005</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Румянцева</surname><given-names>Е. 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Саляма Адиля, д. 2/44</p></bio><bio xml:lang="en"><p>Ok Nam Li, MD, PhD.</p><p>2/44 Salyama Adilya Str., Moscow 123423</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8830-7231</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ломакин</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lomakin</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> </p><p>Ломакин Никита Валерьевич, д.м.н., проф.</p><p>121359 Москва, ул. Маршала Тимошенко, д. 15</p><p>125993 Москва, Баррикадная ул., д. 2/1</p></bio><bio xml:lang="en"><p>Nikita V. Lomakin, MD, Dr Sci Med, Prof.</p><p>15 Marshala Timoshenko Str., Moscow 121359</p><p>2/1 Barrikadnaya Str., Moscow 125993</p></bio><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9899-9910</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гри</surname><given-names>Ж.-К.</given-names></name><name name-style="western" xml:lang="en"><surname>Gris</surname><given-names>J.-Ch.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гри Жан-Кристоф, д.м.н., проф., иностранный член РАН</p><p>Scopus Author ID: 7005114260. WoS ResearcherID: AAA-2923-2019</p><p>Россия, 119048 Москва, ул. Трубецкая, д. 8, стр. 2</p><p>34090 Монпелье, ул. Огюста Бруссоне, д. 163</p></bio><bio xml:lang="en"><p>Jean-Christophe Gris, MD, Dr Sci Med, Prof., Foreign Member of RAS</p><p>Scopus Author ID: 7005114260. 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WoS ResearcherID: AAC-9695-2019</p><p>8 bldg. 2, Trubetskaya Str., Moscow 119048, Russia</p><p>12 Rue de la Faculté de Médecine, Paris 75006</p><p>4 Rue de la Chine, Paris 75020</p></bio><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2316-6348</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Геротзиафас</surname><given-names>Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Gerotziafas</surname><given-names>G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Геротзиафас Григориос, д.м.н., проф., иностранный член РАН</p><p>Россия, 119048 Москва, ул. Трубецкая, д. 8, стр. 2</p><p>75006 Париж, Улица медицинского факультета, д. 12</p><p>75020 Париж, Китайская улица, д. 4</p></bio><bio xml:lang="en"><p>Grigoriоs Gerotziafas, MD, Dr Sci Med, Prof., Foreign Member of RAS</p><p>8 bldg. 2, Trubetskaya Str., Moscow 119048, Russia</p><p>12 Rue de la Faculté de Médecine, Paris 75006</p><p>4 Rue de la Chine, Paris 75020</p></bio><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7415-4633</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макацария</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Makatsariya</surname><given-names>A. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Макацария Александр Давидович, д.м.н., проф., академик РАН</p><p>Scopus Author ID: 57222220144. WoS ResearcherID: M-5660-2016</p><p>119048 Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Alexander D. Makatsariya, MD, Dr Sci Med, Prof., Academician of RAS</p><p>Scopus Author ID: 57222220144. WoS ResearcherID: M-5660-2016</p><p>8 bldg. 2, Trubetskaya Str., Moscow 119048</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Институт Превентивной и Социальной Медицины ; АНО ДПО «Московский медико-социальный институт имени Ф.П. Гааза» ; ФГБУ «Федеральный научно-клинический центр медицинской реабилитации и курортологии Федерального медико-биологического агентства»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute for Preventive and Social Medicine ; Moscow Haass Medical – Social Institute ; Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology, Federal Medical-Biological Agency</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Sechenov University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Научно-исследовательский институт урологии и интервенционной радиологии имени Н.А. Лопаткина – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Lopatkin Research Institute of Urology and Interventional Radiology – Branch of National Medical Research Radiological Centre, Health Ministry of Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ФГАОУ ВО «Московский государственный технический университет имени Н.Э. Баумана (национальный исследовательский университет)»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Bauman Moscow State Technical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ГБУЗ «Городская клиническая больница № 67 имени Л.А. Ворохобова ДЗМ»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Vorokhobov City Clinical Hospital No. 67, Moscow Healthcare Department</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>ФГБУ «Центральная клиническая больница с поликлиникой» Управления делами Президента Российской Федерации ; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Central Clinical Hospital with a Polyclinic of the Administrative Directorate of the President of the Russian Federation ; Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет) ; Университет Монпелье</institution><country>Франция</country></aff><aff xml:lang="en"><institution>Sechenov University ; University of Montpellier</institution><country>France</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)  ; Медицинский Университет Сорбонны ; Госпиталь Тенон</institution><country>Франция</country></aff><aff xml:lang="en"><institution>Sechenov University ; Medicine Sorbonne University; Hospital Tenon</institution><country>France</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>10</day><month>05</month><year>2026</year></pub-date><volume>20</volume><issue>2</issue><fpage>281</fpage><lpage>302</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Blinov D.V., Solopova A.G., Bitsadze V.O., Khizroeva J.K., Tretyakova M.V., Gashimova N.R., Grigoreva K.N., Kiykova P.S., Khisamieva A.R., Oskolkova A.R., Vorobev A.V., Khazan P.L., Mnatsakanyan A.N., Rumyantseva E.I., Li O.N., Lomakin N.V., Gris J., Elalamy I., Gerotziafas G., Makatsariya A.D., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Блинов Д.В., Солопова А.Г., Бицадзе В.О., Хизроева Д.Х., Третьякова М.В., Гашимова Н.Р., Григорьева К.Н., Кийкова П.С., Хисамиева А.Р., Осколкова А.Р., Воробьев А.В., Хазан П.Л., Мнацаканьян А.Н., Румянцева Е.И., Ли О.Н., Ломакин Н.В., Гри Ж., Элалами И., Геротзиафас Г., Макацария А.Д.</copyright-holder><copyright-holder xml:lang="en">Blinov D.V., Solopova A.G., Bitsadze V.O., Khizroeva J.K., Tretyakova M.V., Gashimova N.R., Grigoreva K.N., Kiykova P.S., Khisamieva A.R., Oskolkova A.R., Vorobev A.V., Khazan P.L., Mnatsakanyan A.N., Rumyantseva E.I., Li O.N., Lomakin N.V., Gris J., Elalamy I., Gerotziafas G., Makatsariya A.D.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.gynecology.su/jour/article/view/2802">https://www.gynecology.su/jour/article/view/2802</self-uri><abstract><p>Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), remains a global health challenge. Modern advances in the management of acute VTE, such as the introduction of direct oral anticoagulants and interventional techniques, have led to a significantly decreased mortality rate, that however was simultaneously accounted for by a growing population of patients living with long-term disabling sequelae. The key complications are post-thrombotic syndrome (PTS) developing in 20–50 % of DVT patients that manifests as chronic venous insufficiency, edema, pain, and venous ulcers as well as chronic thromboembolic pulmonary hypertension (CTEPH), which occurs in up to 4.0 % of PE survivors and leads to progressive dyspnea, heart failure, and reduced exercise tolerance. The pathogenesis of these conditions is based on incomplete vein recanalization, valvular damage, persistent inflammation, and endothelial dysfunction in PTS, as well as thrombus organization and pulmonary vascular remodeling resulting in right heart failure in CTEPH. This article emphasizes the necessity to shift from an acute-event treatment model to a continuous chronic disease management paradigm. Effective rehabilitation requires a comprehensive multidisciplinary assessment, utilizing subjective scales and questionnaires alongside objective methods (duplex ultrasound, echocardiography, and cardiopulmonary exercise testing). Key components of a rehabilitation program include optimization of anticoagulation, nutritional support, compression therapy, early mobilization, and structured physical training to enhance the muscle-venous pump mechanism and cardiorespiratory fitness, as well as psychosocial support and lifestyle modification. VTE rehabilitation despite obvious demand faces a lack of standardized protocols, a scarcity of high-quality research, and unequal access to specialized care. Future directions include personalizing programs through risk stratification, utilizing telemedicine to improve treatment adherence, and developing clinical guidelines focused on long-term functional recovery and improved patients’ quality of life.</p></abstract><trans-abstract xml:lang="ru"><p>Венозная тромбоэмболия (ВТЭ), включающая тромбоз глубоких вен (ТГВ) и тромбоэмболию легочной артерии (ТЭЛА), является глобальной проблемой здравоохранения. Современные успехи в лечении острой фазы ВТЭ, такие как внедрение прямых пероральных антикоагулянтов и интервенционных методов, привели к значительному снижению летальности, но одновременно обусловили рост популяции пациентов с долгосрочными инвалидизирующими последствиями. Ключевыми осложнениями являются посттромботический синдром (ПТС), развивающийся у 20–50 % перенесших ТГВ и проявляющийся хронической венозной недостаточностью, отеком, болью и трофическими язвами, а также хроническая тромбоэмболическая легочная гипертензия (ХТЭЛГ), возникающая у до 4,0 % выживших после ТЭЛА и приводящая к прогрессирующей одышке, сердечной недостаточности и снижению толерантности к нагрузкам. В основе патогенеза этих состояний лежат неполная реканализация вен, клапанная недостаточность, персистирующее воспаление и дисфункция эндотелия при ПТС, а также организация тромбов и ремоделирование легочных сосудов с развитием правожелудочковой недостаточности при ХТЭЛГ. В статье подчеркивается необходимость перехода от модели лечения острого состояния к модели непрерывного управления хроническим заболеванием. Эффективная реабилитация требует комплексной мультидисциплинарной оценки, включающей субъективные шкалы, опросники и объективные методы (дуплексное сканирование вен, эхокардиографию, кардиопульмональное нагрузочное тестирование). Ключевыми компонентами реабилитационной программы выступают оптимизация антикоагулянтной терапии, нутрициальная поддержка, компрессионная терапия, ранняя активизация и дозированные физические тренировки для улучшения функции мышечно-венозной помпы и кардиореспираторной выносливости, а также психосоциальная коррекция и модификация образа жизни. Несмотря на очевидную потребность, реабилитация при ВТЭ сталкивается с нехваткой стандартизированных протоколов, дефицитом качественных исследований и неравномерной доступностью специализированной помощи. Перспективными направлениями являются персонализация программ на основе стратификации риска, использование телемедицинских технологий для повышения приверженности лечению и разработка клинических рекомендаций, ориентированных на долгосрочное функциональное восстановление и улучшение качества жизни пациентов.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>венозная тромбоэмболия</kwd><kwd>ВТЭ</kwd><kwd>тромбоз глубоких вен</kwd><kwd>ТГВ</kwd><kwd>тромбоэмболия легочной артерии</kwd><kwd>ТЭЛА</kwd><kwd>посттромботический синдром</kwd><kwd>ПТС</kwd><kwd>хроническая тромбоэмболическая легочная гипертензия</kwd><kwd>ХТЭЛГ</kwd><kwd>реабилитация</kwd><kwd>качество жизни</kwd><kwd>функциональное восстановление</kwd></kwd-group><kwd-group xml:lang="en"><kwd>venous thromboembolism</kwd><kwd>VTE</kwd><kwd>deep vein thrombosis</kwd><kwd>DVT</kwd><kwd>pulmonary embolism</kwd><kwd>PE</kwd><kwd>post-thrombotic syndrome</kwd><kwd>PTS</kwd><kwd>chronic thromboembolic pulmonary hypertension</kwd><kwd>CTEPH</kwd><kwd>rehabilitation</kwd><kwd>quality of life</kwd><kwd>functional recovery</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">New H., Byers C.G. 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