Iliofemoral venous thrombosis caused by compression of an internal iliac artery aneurysm: a minimally invasive treatment.
OBJECTIVE
To report the success of a minimally invasive treatment for phlegmasia cerulea dolens without gangrene caused by compression from an internal iliac artery aneurysm.


RESULTS
An 81-year-old male with a 1-month history of paralysis owing to a hemorrhagic stroke presented with massive edema and skin mottling of the right lower extremity. Imaging confirmed right iliofemoral deep vein thrombosis caused by compression from a 4-cm internal iliac artery aneurysm. With thrombolysis ruled out, a minimally invasive treatment plan was undertaken, featuring percutaneous coil embolization of the aneurysm and surgical venous thrombectomy with proximal arteriovenous fistula creation and iliac vein stent placement. Failure of the coils to embolize the iliac aneurysm prompted the use of an endovascular graft to exclude the aneurysm. The patient's symptoms subsided, and he has a patent right iliofemoral venous system and internal iliac artery at his latest (16-month) follow-up.


CONCLUSIONS
This case demonstrates that minimally invasive endovascular and open techniques can be combined to achieve an optimum outcome in patients at high risk for standard surgical approaches.
Rosenthal
D
D
Department of Vascular Surgery, Georgia Baptist Medical Center, Medical College of Georgia, Atlanta 30312, USA.
Matsuura
J H
JH
Jerius
H
H
Clark
M D
MD
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications*; D001166:Arteriovenous Shunt, Surgical; D019917:Blood Vessel Prosthesis Implantation; D004621:Embolization, Therapeutic; D005268:Femoral Vein; D006801:Humans; D007083:Iliac Artery; D007084:Iliac Vein; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011312:Pressure; D015607:Stents; D013924:Thrombophlebitis / Q000209:etiology* / Q000601:surgery*