title: Successful catheter directed thrombolysis in postpartum deep venous thrombosis complicated by nicoumalone-induced skin necrosis and failure in retrieval of inferior vena caval filter.
abstract: Venous thromboembolism is an important cause for maternal morbidity and mortality in postpartum period. Though catheter-directed thrombolysis (CDT) is now considered as a safe and effective therapy for the management of deep venous thrombosis (DVT) but still it is not indicated in postpartum DVT. We are presenting a case of 22-year-old female patient who presented with post-partum lower limb DVT and managed successfully with CDT by using injection streptokinase and temporary inferior vena caval filter was inserted as prophylactic for pulmonary embolism as she had extensive DVT extending into inferior vena cava (IVC). During follow-up, she developed large skin necrosis in left lower limb which was managed by adding injection low-molecular-weight heparin. IVC filter also could not be retrieved even after trying all manoeuvres during follow-up after 2 weeks.
authors.affiliation: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bengaluru, Karnataka, India.
authors.forename: B C
authors.initials: BC
authors.lastname: Srinivas
authors.forename: Soumya
authors.initials: S
authors.lastname: Patra
authors.forename: Navin
authors.initials: N
authors.lastname: Agrawal
authors.forename: C N
authors.initials: CN
authors.lastname: Manjunath
mesh_terms: D000074:Acenocoumarol / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects; D002406:Catheterization, Peripheral; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply; D009336:Necrosis / Q000139:chemically induced; D011644:Puerperal Disorders / Q000188:drug therapy*; D012867:Skin / Q000473:pathology*; D013300:Streptokinase / Q000008:administration & dosage*; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D013300:Streptokinase; D000074:Acenocoumarol