Endoluminal recanalization in a patient with phlegmasia cerulea dolens using a multimodality approach.
Phlegmasia cerulea dolens, a rare complication of deep venous thrombosis, has traditionally been difficult to treat. The patient described in this report posed additional therapeutic challenges based on a history of heparin-induced thrombocytopenia. She presented with severe leg pain and swelling, and a venogram showed occlusion of both her inferior vena cava and right iliac vein. The use of a multimodality approach, both chemical and mechanical, was successful in removing the venous occlusion, thereby preventing further complications, such as circulatory shock, postphlebitic syndrome, and venous gangrene.
Mousa
Albeir
A
Department of Vascular Surgery, New York Presbyterian Hospital, Cornell University, Weill Medical School, New York, NY, USA.
Henderson
Peter
P
Dayal
Rajeev
R
Bernheim
Joshua
J
Kent
K Craig
KC
Faries
Peter L
PL
D002404:Catheterization / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005263:Femoral Artery; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007084:Iliac Vein; D008875:Middle Aged; D011859:Radiography; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator