Percutaneous Mechanical Thrombectomy in Phlegmasia Cerulea Dolens: Case Report and Literature Review

Vinha, André; Pimenta, Joana; Vasconcelos, João; Maia, Maria Ambrosina Cardoso; Vidoedo, José; Pinto, João Almeida

doi:10.48729/pjctvs.227

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“…The use of IVUS-guided thrombus removal has shown promise in improving procedural success rates and reducing the risk of complications. IVUS allows real-time imaging of the vessel lumen, enabling accurate assessment of the thrombus burden and identification of under-expanded stents [ 7 ]. In our case, we performed IVUS-guided thrombus removal to address the extensive thrombus burden within the iliac and femoral venous stents, facilitating precise localization of the thrombus and enhancing the success of thrombus extraction.…”

Section: Discussionmentioning

confidence: 99%

Successful Intravascular Ultrasound-Guided Thrombus Removal and Angioplasty for Phlegmasia Cerulea Dolens in a Young Male With a History of Multiple Lower Extremity Deep Vein Thrombosis

Patel¹,

Mulukutla²,

Mistry³

et al. 2023

Cureus

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Phlegmasia cerulea dolens is a rare and severe form of deep venous thrombosis (DVT), characterized by an extensive thrombus burden and compromised venous outflow. We present the case of a 28-year-old male with a history of bilateral lower extremity DVTs and multiple venous stents who presented with acute-onset pain and swelling in the left lower extremity. Diagnostic imaging confirmed an acute DVT extending throughout the left lower extremity, including the external iliac vein. Given the diagnosis of phlegmasia cerulea dolens, a multidisciplinary approach involving interventional cardiology, orthopedic surgery, and vascular surgery was adopted. Intravascular ultrasound (IVUS)-guided thrombus removal and angioplasty were performed to restore venous outflow and improve limb perfusion. The procedure successfully removed a significant amount of thrombus and improved flow throughout the venous system. The patient exhibited an excellent clinical response, with pain resolution and improved perfusion. This case highlights the challenges and effectiveness of a combined intervention in managing complex phlegmasia cerulea dolens cases with previous venous stents.

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Section: Discussionmentioning

confidence: 99%