Phlegmasia Cerulea Dolens: A Life-Threatening Manifestation of Deep Vein Thrombosis

Kou, Chung-ting J; Batzlaff, Caitlin; Bezzant, Matthew; Sjulin, Tyson

doi:10.7759/cureus.8587

Cited by 10 publications

(21 citation statements)

References 21 publications

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“…PCD is a rare manifestation of DVT that results from complete obstruction of venous return of the lower extremity commonly seen with combined iliofemoral vein occlusion, leading to thrombosis of venous capillaries and eventual ischemia and gangrene. 3 The presence of PCD is associated with 12% to 50% amputation rate and 20% to 41% mortality rate. 3 CDT is indicated within 72 hours of symptom onset for patients presenting with PCD secondary to iliofemoral DVT to avoid amputation.…”

Section: Discussionmentioning

confidence: 99%

“… 3 The presence of PCD is associated with 12% to 50% amputation rate and 20% to 41% mortality rate. 3 CDT is indicated within 72 hours of symptom onset for patients presenting with PCD secondary to iliofemoral DVT to avoid amputation. 1 , 4 , 8 Localized bleeding is the most common complication, accounting for 5% to 11% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…1 The mainstay of treatment are endovascular interventions: catheter directed thrombolysis (CDT) and pharmacomechanical thrombectomy (PMT). [1][2][3][4] The cause of PCD is multifactorial with inferior vena cava (IVC) filter thrombosis as one proposed risk factor. 3,5 The mechanism of lacunar infarcts is classically taught to be a result of microvascular changes of small cerebral arterioles rather than emboli.6 Patent foramen ovale (PFO) are present in up to 25% of the population and are sources for up to 50% of emboli.7 Here we report a 78year-old female with thalamic stroke following multimodal endovascular intervention for PCD.…”

Section: Introductionmentioning

confidence: 99%

“… 1 The mainstay of treatment is endovascular interventions: catheter directed thrombolysis (CDT) and pharmacomechanical thrombectomy. 1 , 2 , 3 , 4 The cause of PCD is multifactorial with inferior vena cava (IVC) filter thrombosis as one proposed risk factor. 3 , 5 …”

mentioning

confidence: 99%

“… 1 , 2 , 3 , 4 The cause of PCD is multifactorial with inferior vena cava (IVC) filter thrombosis as one proposed risk factor. 3 , 5 …”

mentioning

confidence: 99%

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Lacunar cerebral infarction following endovascular interventions for phlegmasia cerulea dolens

Otto

Ciampa

Martin

2021

Journal of Vascular Surgery Cases, Innovations and Techniques

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Phlegmasia cerulea dolens is a rare presentation of deep venous thrombus treated with catheter directed thrombolysis and pharmacomechanical thrombectomy. This is the case of a 78-year-old woman who underwent catheter directed thrombolysis to treat phlegmasia cerulea dolens and subsequently developed left-sided hemiplegia and expressive aphasia in the setting of an international normalized ratio of 2.0. Further imaging revealed a lacunar infarct in the right thalamus with a middle cerebral artery distribution. Further workup revealed a patent foramen ovale. We highlight the unexpected enigmatic consequence from multimodal endovascular intervention, the consequence of long-term inferior vena cava filters.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

“… 1 , 2 , 3 , 4 The cause of PCD is multifactorial with inferior vena cava (IVC) filter thrombosis as one proposed risk factor. 3 , 5 …”

mentioning

confidence: 99%

See 3 more Smart Citations

Lacunar cerebral infarction following endovascular interventions for phlegmasia cerulea dolens

Otto

Ciampa

Martin

2021

Journal of Vascular Surgery Cases, Innovations and Techniques

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Massive DVT from the proximal IVC to the pedal vein: Our approach using aspiration mechanical thrombectomy and open surgery thrombectomy

Pandelaki

Hadibrata²,

Sini³

et al. 2023

Radiology Case Reports

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Current state of treatment for lower extremity acute deep venous thrombosis (a literature review)

Nykonenko¹,

Vailo²,

Матерухін³

2021

ZMJ

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Despite the use of modern methods of diagnosis and treatment, deep vein thrombosis (DVT) of the lower extremities remains a fairly common disease. In half of all cases, DVT may be asymptomatic and manifest itself in subsequent symptoms of pulmonary embolism (PE) or postthrombotic syndrome (PTS). An important role in the pathogenesis of this disease is played by a variety of factors and conditions that contribute to thrombosis in the venous vessels of the lower extremities, as well as impaired venous outflow from the lower extremity due to blockage of the venous lumen by such a thrombus. The action of various treatments is aimed at certain links in the pathogenesis, namely: anticoagulant therapy prevents further thrombosis, thrombolysis dissolves blood clots, surgical and mechanical thrombectomy remove blood clots from the lumen of the vein, lysis or removal of thrombotic masses restores thrombosis in the small circle of blood circulation. There is no single, universal method for combating DVT. In addition, there are new methods, such as the use of devices for pharmaco-mechanical thrombolysis, stent-retrievers which need to be tested for effectiveness and safety, as well as for a comparative analysis with existing treatments. Given the severe consequences of DVT that include early mortality, recurrence and complications of the disease, and can be associated with death, rehospitalization, deterioration in patient quality of life and disability, the choice and application of certain treatments or combinations thereof becomes important. Equally important are the issues of primary and secondary prevention of DVT, which reduce the above-mentioned risks and should be pursued in each patient. The aim. To study the world experience in the treatment of DVT, to summarize modern approaches to the treatment of patients with DVT based on the principles of evidence-based medicine by reviewing and analyzing modern scientific literary sources in scientometric bases. Materials and methods. We searched for publications in scientometric databases including Pub Med, Google Scholar, Web of Sciense, Scopus by keywords, as well as for the latest recommendations and guidelines that cover modern methods of diagnosis and treatment of DVT of the lower extremities. Articles, systematic reviews and literature relevant to the research topic were reviewed and analyzed. The inclusion criteria were: articles and studies describing to the pathophysiology, diagnosis and treatment of DVT, studies with the longest observation, recommendations and guidelines of professional associations regarding DVT. The exclusion criteria were: articles not related to the research topic, a small number of patients included in the study (less than 15 people). Conclusions. DVT and its complications can lead to fatal conditions, such as pulmonary embolism, and often adversely affect patients’ quality of life. DVT is potentially life-threatening and should be considered by a physician and patient as a life-threatening disease. Anticoagulant therapy is the main option for both DVT treatment and secondary prevention of venous thromboembolism and PTS recurrence. Some patients may receive drug therapy on an outpatient basis. Other patients with severe disease and complications need inpatient management. An open surgery, percutaneous endovascular procedures and various combinations thereof with the addition of anticoagulant therapy could be applied to this group. The lack of clear criteria for selecting patients and indications for endovascular interventions and surgical thrombectomy requires further research in this area.

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Phlegmasia Cerulea Dolens: A Life-Threatening Manifestation of Deep Vein Thrombosis

Cited by 10 publications

References 21 publications

Lacunar cerebral infarction following endovascular interventions for phlegmasia cerulea dolens

Lacunar cerebral infarction following endovascular interventions for phlegmasia cerulea dolens

Massive DVT from the proximal IVC to the pedal vein: Our approach using aspiration mechanical thrombectomy and open surgery thrombectomy

Current state of treatment for lower extremity acute deep venous thrombosis (a literature review)

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