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

Nikolaos Galanakis1, Nikolaos Kontopodis2, Elias Kehagias1

  • 1Interventional Radiology Unit, Department of Medical Imaging, University Hospital of Heraklion, University of Crete Medical School, Heraklion, Greece.

Vascular Specialist International
|December 27, 2021
PubMed

Insights

Phlegmasia cerulea dolens (PCD), a severe deep vein thrombosis complication, was successfully treated with direct iliac vein stenting. This case highlights stenting as an effective alternative for May-Thurner syndrome-related iliofemoral DVT.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Phlegmasia cerulea dolens (PCD) is a rare, severe complication of acute deep vein thrombosis (DVT).
  • May-Thurner syndrome (MTS) is an anatomical variant involving iliac vein compression, a less common cause of DVT and PCD.

Observation:

  • A 56-year-old male presented with symptoms of PCD.
  • Color Doppler ultrasonography identified extensive left iliofemoral DVT.
  • Contrast-enhanced CT confirmed MTS as the underlying cause of the iliofemoral DVT.

Findings:

  • Initial iliofemoral thrombectomy was unsuccessful.
  • An inferior vena cava filter was deployed.
  • Direct iliac vein stenting achieved immediate recanalization of the thrombotic occlusion.
  • The patient showed significant clinical improvement and was discharged within two days.

Implications:

  • May-Thurner syndrome is a rare but significant cause of PCD.
  • Direct iliac vein stenting offers a safe and effective treatment option for rapid recanalization in MTS-related iliofemoral DVT.
  • Stenting serves as a valuable alternative when percutaneous mechanical thrombectomy devices are unavailable.

Keywords:
Deep venous thrombosisDirect stentingMay-Thurner syndromePhlegmasia cerulea dolens

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