Delayed Yet Successful Mechanical Thrombectomy for Phlegmasia Cerulea Dolens in a Limb with Severe Arterial Disease and May-Thurner Syndrome

Case Reports in Vascular Medicine
Ahmad SaidLuay Sayed

Abstract

Phlegmasia cerulea dolens (PCD) is a rare but life-threatening complication of acute deep venous thrombosis that lacks consensus regarding the approach to management. We present a case of PCD developing shortly after a spinal surgery and manifesting as acute swelling and discoloration in a leg with existing severe atherosclerotic arterial disease. The patient's critical limb ischemia was completely and rapidly reversed by percutaneous mechanical thrombectomy using the ClotTriever device despite a delay in treatment. An underlying iliac vein compression "May-Thurner" syndrome was discovered using intravascular ultrasound and treated with angioplasty. This case identifies mechanical thrombectomy using the ClotTriever system as a possible effective and safe treatment for PCD.

References

May 23, 2018·Techniques in Vascular and Interventional Radiology·Jeffrey Forris Beecham ChickSteven D Abramowitz
May 28, 2019·International Journal of Surgery Case Reports·Ayman S ELsaidBander Fuhaid Aldhafery
Jul 25, 2019·Journal of Vascular Surgery Cases and Innovative Techniques·Jason R Crowner, William Marston
Dec 18, 2019·Journal of Vascular Surgery. Venous and Lymphatic Disorders·Jaime Benarroch-GampelRobert Crawford
Dec 25, 2019·Journal of Vascular Surgery Cases and Innovative Techniques·Nariman NezamiJuan Carlos Perez Lozada

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Methods Mentioned

BETA
amputation
percutaneous transluminal angioplasty

Software Mentioned

ClotTriever

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