Syndromes Associated With the Deep Veins: Phlegmasia Cerulea Dolens, May-Thurner Syndrome, and Nutcracker Syndrome

Suwanabol, Pasithorn A.; Tefera, Girma; Schwarze, Margaret L.

doi:10.1177/1531003511400426

Cited by 60 publications

(62 citation statements)

References 58 publications

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“…However, that alone is not adequate for the treatment of DVT with May-Thurner, as it fails to address any of the long-term sequelae in this group of pacients. [10] May-Thurner syndrome, in which the overriding right iliac artery compresses the left iliac vein, will rarely respond to conservative treatments, [11] including anticoagulation and fibrinolysis [12], given the physical etiology of the disease. [11] Pacients with iliofemoral thrombosis and May-Thurner should be treated aggressively with catheter directed thrombolysis, percutaneous mechanical trombectomy and angioplasty and stent placement across the common iliac stenosis.…”

Section: Discussionmentioning

confidence: 99%

“…[13] Operative intervention for May-Thurner with acute thrombosis includes thrombectomy with adjunctive arteriouvenous fistula and relief of the distal iliac obstructionn via dissection of the right common iliac artery off the left common iliac vein. [10] Therefore, early recognition and endovascular treatment of iliac vein compression could prevent a DVT and an improvement in the symptoms. [1] The treatment, however, depends on the presence of DVT.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The therapeutic approach of the May-Thurner Syndrome without Deep Venous Thrombosis: a systematic review

Neto

Luedy²,

Costa³

et al. 2017

int arch med

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May-Thurner Syndrome is a clinical condition which causes a variety of vascular symptoms, resulting from pelvic and lower extremity venous flow obstruction caused by the compression of the iliac vein by overlying iliac artery. Treatment paradigms have changed as experience with endovascular modalities has evolved, making traditional surgical treatment strategies essentially obsolete and a endovascular treatment with angioplasty and stenting along selective thrombolysis has become the standard for symptomatic the syndrome. The objective of this present study is to show the therapeutic approach in treatment when there's no presence of Deep Venous Thrombosis (DVT) symptoms. To accomplish this purpose, a systematic review of articles about May-Thurner Syndrome and its management therapies,

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The therapeutic approach of the May-Thurner Syndrome without Deep Venous Thrombosis: a systematic review

Neto

Luedy²,

Costa³

et al. 2017

int arch med

View full text Add to dashboard Cite

show abstract

“…5,16 In the case of a DVT associated with MTS, systemic anticoagulation alone is not adequate, as it fails to address the underlying anatomical compression. 24,25 It is suggested that the anatomical defect should be repaired with the use of stents and balloon venoplasty. 11 Patients with a high clot burden should also undergo inferior vena cava filter placement.…”

Section: Managementmentioning

confidence: 99%

Multiple Venous Thromboses Presenting as Mechanical Low Back Pain in an 18-Year-Old Woman

Marchand

Boucher

O’Shaughnessy

2015

Journal of Chiropractic Medicine

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Objective: The purpose of this case report is to describe a patient who presented with acute musculoskeletal symptoms but was later diagnosed with multiple deep vein thrombosis (DVT). Clinical Features: An 18-year-old female presented to a chiropractic clinic with left lumbosacral pain with referral into the posterior left thigh. A provisional diagnosis was made of acute myofascial syndrome of the left piriformis and gluteus medius muscles. The patient received 3 chiropractic treatments over 1 week resulting in 80% improvement in pain intensity. Two days later, a sudden onset of severe abdominal pain caused the patient to seek urgent medical attention. A diagnostic ultrasound of the abdomen and pelvis were performed and interpreted as normal. Following this, the patient reported increased pain in her left leg. Evaluation revealed edema of the left calf and decreased left lower limb sensation. A venous Doppler ultrasound was ordered. Intervention and Outcomes: Doppler ultrasound revealed reduction of the venous flow in the femoral vein area. An additional ultrasonography evaluation revealed an extensive DVTs affecting the left femoral vein and iliac axis extending towards the vena cava. Upon follow-up with a hematologist, the potential diagnosis of May-Thurner syndrome was considered based on the absence of blood dyscrasias and sustained anatomical changes found in the left common iliac vein at its junction with the right common iliac artery. A week following discharge, she presented with chest pain and was diagnosed with venous thromboembolism. The patient was successfully treated with anticoagulation therapy and insertion of a vena cava filter. Conclusion: Although DVTs are common in the general population, presence in low-risk individuals may be overlooked. In the presence of subtle initial clinical signs such as those described in this case report, clinicians should keep a high index of suspicion for a DVT.Rapid identification of such clinical signs in association with a lack of objective examination findings warrants further evaluation due to potentially negative outcomes.

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“…1 Risk factors for PCD include malignancy, immobility, heart failure, heparin-induced thrombocytopenia, prothrombin states (eg, antiphospholipid syndrome), pregnancy, surgery and venous instrumentation (eg, placement of central venous catheters and inferior vena cava filters). 2 Clinically, PCD is characterized by sudden pain, swelling, purple ecchymosis, and arterial ischemia with loss of distal pulses. 3 Edema develops rapidly, and the skin of the affected extremity is usually tense, firm, and tender to palpation.…”

mentioning

confidence: 99%

“…Doppler ultrasound of the affected extremity should be used to confirm the diagnosis of PCD, and initial treatment includes bed rest, elevation of the affected limb, and systemic anticoagulation with heparin. 2 Catheter-directed thrombolysis and venous thrombectomy should also be considered as early treatment options for PCD. 4 v …”

mentioning

confidence: 99%

Images in Emergency Medicine: Phlegmasia Cerulea Dolens

Levis¹

2013

TPJ

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Syndromes Associated With the Deep Veins: Phlegmasia Cerulea Dolens, May-Thurner Syndrome, and Nutcracker Syndrome

Cited by 60 publications

References 58 publications

The therapeutic approach of the May-Thurner Syndrome without Deep Venous Thrombosis: a systematic review

The therapeutic approach of the May-Thurner Syndrome without Deep Venous Thrombosis: a systematic review

Multiple Venous Thromboses Presenting as Mechanical Low Back Pain in an 18-Year-Old Woman

Images in Emergency Medicine: Phlegmasia Cerulea Dolens

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