title: Trends in management of phlegmasia cerulea dolens.
abstract: Phlegmasia cerulea dolens (PCD) is a fulminant condition of acute massive venous thrombosis that may result in major amputation or death unless treated in an early phase. Guidelines for treatment are still not clearly documented. As a consequence, physicians might have limited knowledge of this potential life-threatening condition and its clinical course. Therefore, the purpose of this review was to analyze and summarize clinical manifestations and proposed diagnostic approach, factors that affect the outcome of PCD, and the evolution of management and therapeutic options. Underlying malignancy, pulmonary embolism, and PCD severity are the vital factors that predict the outcome of PCD. In the last decades, treatment options have remained largely unchanged. Published evidence shows that advances in minimally invasive techniques have not yet resulted in outcome improvements compared with traditional surgical thrombectomy. Treatment seems to depend on grading the severity of this condition and experience of the surgeon.
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Khamin
authors.initials: K
authors.lastname: Chinsakchai
authors.forename: Kaj
authors.initials: K
authors.lastname: Ten Duis
authors.forename: Frans L
authors.initials: FL
authors.lastname: Moll
authors.forename: Gert J
authors.initials: GJ
authors.lastname: de Borst
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000639:trends; D057510:Endovascular Procedures / Q000639:trends*; D005260:Female; D005734:Gangrene; D006801:Humans; D023821:Limb Salvage / Q000639:trends; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000639:trends*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*