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Updated: Sep 26, 2026

New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
Published on: June 27, 2025
[Veinous thrombectomy. Six case reports]
Abdelfettah Abid1, Raouf Denguir, Karim Kaouel
1Service de Chirurgie Cardio-vasculaire, Hôpital La Rabta, Tunis, Tunisie.
Insights
Surgical venous thrombectomy effectively treats phlegmasia cerulea dolens, relieving ischemia and preventing chronic venous disorders. Fibrinolytic therapy is an alternative, but surgery is reserved for severe, limb-threatening cases.
Area of Science:
- Vascular Surgery
- Vascular Medicine
Background:
- Phlegmasia cerulea dolens (PCD) is a rare, severe form of deep vein thrombosis.
- Prompt treatment is crucial to prevent limb ischemia and loss.
Observation:
- This retrospective study analyzed 6 patients with PCD (mean age 63).
- All patients underwent surgical venous thrombectomy; 2 also received an IVC filter.
- One patient died postoperatively; others showed good early and late outcomes.
Findings:
- Surgical venous thrombectomy demonstrated good clinical and duplex scan outcomes in PCD patients.
- The procedure effectively relieved ischemia and prevented chronic venous disorders.
Implications:
- Surgical thrombectomy is an efficient treatment for PCD, especially in limb-threatening ischemia.
- Fibrinolytic therapy may offer similar results and should be considered.
- Surgery is best reserved for cases where fibrinolysis fails or is contraindicated.
Abstract:
The aim of this study is to raise up the effect of surgical thrombectomy among other alternative therapies. This retrospective study reports 6 patients (mean age 63 years) admitted with phlegmasia cerulea dolens. All patients underwent surgical venous thrombectomy associated with infracava filter insertion in 2 cases. One patient died in the early postoperative course. In all other cases we noticed good early and late outcome both on clinical examination and duplex scanning assessment. In conclusion, surgical venous thrombectomy can be considered as a good and efficient procedure in the presence of phlegmasia cerulea dolens in order to relieve ischemia and to prevent whenever possible severe chronic venous disorders. However, fibrinolytic therapy might achieve as good results as surgery. Thus, the latter is to be reserved to very severe veinous ischemia with limb loss threatening where fibrinolytic therapy fails or is contre-indicated.
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