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Management of Phlegmasia Cerulea Dolens with Percutaneous Mechanical Thrombectomy

Ramsey A Al-Hakim1, Alexander Boscanin2, David D Prosser2

  • 1Dotter Department of Interventional Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA. alhakim@ohsu.edu.

Cardiovascular and Interventional Radiology
|July 1, 2020
PubMed

Insights

Advanced phlegmasia cerulea dolens (PCD) requires rapid intervention. Emergent mechanical thrombectomy using the ClotTriever device successfully restored venous flow and clinical symptoms in a severe PCD case.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Phlegmasia cerulea dolens (PCD) is a severe venous obstruction causing limb ischemia.
  • Advanced PCD cases with critical limb ischemia indicators necessitate urgent reperfusion to prevent limb loss and mortality.

Observation:

  • A case of severe phlegmasia cerulea dolens with absent pedal pulses and sensory deficits was treated.
  • The patient underwent emergent percutaneous mechanical thrombectomy.

Findings:

  • The ClotTriever device successfully removed the venous thrombus.
  • Immediate restoration of pedal pulses and resolution of sensory deficits were observed within 45 minutes post-procedure.
  • Venous flow was rapidly restored, reversing PCD pathophysiology.

Implications:

  • Percutaneous mechanical thrombectomy with the ClotTriever offers a rapid and effective treatment for severe phlegmasia cerulea dolens.
  • This approach may serve as a viable alternative to surgical embolectomy for high-severity PCD.
  • Early intervention with mechanical thrombectomy can significantly improve outcomes in critical venous limb ischemia.

Keywords:
Deep venous thrombosisMechanical thrombectomyPhlegmasia cerulea dolens

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