Upper limb phlegmasia cerulea dolens treated with single-session suction thrombectomy: a case report

Abstract

Phlegmasia cerulea dolens (PCD) of the lower limbs is a rare condition. PCD of the upper limbs is extremely uncommon, with only a select few cases documented in the literature. A complication of severe deep venous thrombosis, PCD, is characterized by the clinical triad of oedema, pain and limb cyanosis. Delays in treatment are associated with high rates of morbidity and mortality. We present a case of sudden-onset upper limb PCD in a 68-year-old man following haemodialysis through a long-term arteriovenous fistula. Prompt diagnosis and rapid initiation of intravenous anticoagulation followed by urgent single-session suction thrombectomy resulted in the successful restoration of vessel patency without any significant adverse sequelae on 3-month follow-up.

Surgical Considerations in the Treatment of Axillary-Subclavian Venous Thrombosis in the Era of COVID-19

“…Investigators have previously described the use of percutaneous aspiration and thrombectomy devices for the treatment of axillary-subclavian venous thrombosis with adjunctive thrombolysis. [6][7][8][9][10] However, to the best of our knowledge, successful use of the CAT 8 Indigo catheter in this location without concomitant use of thrombolytic agents has not been previously reported. The ability to clear the clot burden without adjunctive use of a lytic agent increases the potential of this treatment paradigm, particularly of benefit in those patients with high risk for bleeding.…”

Phlegmasia Cerulea Dolens, a Deadly Complication of Deep Vein Thrombosis: Case Report and Review of Literature

“…Despite the advances in medical science due to the rarity of this condition, there is still no consensus regarding the ideal treatment of PCD [ 2 ]. Early diagnosis and supportive treatment with leg elevation, intravenous fluid resuscitation, anticoagulation, along with surgical interventions such as catheter-directed thrombolysis (CDT) or percutaneous thrombectomy, may prevent the complications, as progression to venous gangrene may lead to mortality in up to 57% of cases [ 10 - 11 ]. As per our knowledge, till now there is no case report of PCD associated with a lung abscess and presenting with sepsis.…”