Related Experiment Video

Updated: Aug 10, 2025

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

9.3K

COVID-19-Induced Phlegmasia Cerulea Dolens

Stephanie Cohen1, Joshua Lynch1

  • 1Emergency Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA.

Cureus
|February 15, 2023
PubMed

Insights

A patient with a history of DVT and PE experienced severe limb swelling due to phlegmasia cerulea dolens. Emergency surgery with thrombolysis and thrombectomy successfully restored blood flow, preventing limb loss.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Thrombosis Management

Background:

  • A 44-year-old male with a history of deep venous thrombosis (DVT), pulmonary embolism (PE), inferior vena cava (IVC) filter, and peripheral vascular disease (PVD) presented with critical limb ischemia.
  • The patient exhibited bilateral phlegmasia cerulea dolens with absent distal pulses, indicating a high risk of venous gangrene and limb loss.

Observation:

  • The patient presented from a COVID-19 rehabilitation center with acute bilateral lower extremity swelling and pulselessness.
  • This critical condition placed the patient at immediate risk for limb loss due to compromised venous outflow and arterial supply.

Findings:

  • Emergency vascular surgery was performed, including anticoagulation, thrombolysis with alteplase, and mechanical thrombectomy.
  • Bilateral thrombolysis catheters were utilized for two days, resulting in the return of arterial signals in the feet and a significant reduction in clot burden.

Implications:

  • Successful revascularization and thrombolysis averted limb loss in a patient with complex vascular history and acute limb ischemia.
  • This case highlights the effectiveness of combined interventional and surgical approaches in managing severe phlegmasia cerulea dolens.
  • The patient is expected to make a full recovery, underscoring the importance of timely and aggressive treatment for limb-threatening venous events.

Keywords:
covid-19covid-related hypercoagulabilitydeep vein thrombosis (dvt)phlegmasia cerulea dolenssars-cov2

More Related Videos

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model08:16

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model

Published on: March 16, 2022

3.6K
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease04:44

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

Published on: June 16, 2020

20.0K

Related Concept Videos

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
23
Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs but also impacts other areas, such as the arms, thereby impairing overall circulation and organ function.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty deposits inside the arterial...
15
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
17
Assessment of the Cardiovascular System III: Palpation01:27

Assessment of the Cardiovascular System III: Palpation

Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
410
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
16
Vascular Spasm01:16

Vascular Spasm

The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last...
1.6K