Vasc Spec Int.  2021 Dec;37(4):37. 10.5758/vsi.210031.

Direct Iliac Vein Stenting in Phlegmasia Cerulea Dolens Caused by May–Thurner Syndrome

• Galanakis N
• Kontopodis N
• Kehagias E
• Daskalakis N
• Tsetis K
• Ioannou CV
• Tsetis D

• KMID: 2524495
• DOI: http://doi.org/10.5758/vsi.210031

Abstract

Phlegmasia cerulea dolens (PCD) is an uncommon but potentially limb-threatening complication of acute deep vein thrombosis. A 56-year-old male presented with PCD. Color Doppler ultrasonography revealed extensive thrombosis of the left superficial and common femoral and external and common iliac veins. After an unsuccessful iliofemoral thrombectomy, contrast-enhanced computed tomography revealed iliofemoral deep vein thrombosis due to May–Thurner syndrome (MTS). After the deployment of an inferior vena cava filter, the thrombotic occlusion was traversed with a guidewire and direct stenting was performed to achieve immediate recanalization. The patient was discharged two days after the procedure, demonstrating significant clinical improvement. MTS is a rare cause of PCD. Direct iliac vein stenting may be a safe and effective alternative treatment for rapid recanalization if percutaneous mechanical thrombectomy devices are unavailable.

Keyword

Phlegmasia cerulea dolens; May–Thurner syndrome; Deep venous thrombosis; Direct stenting