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Published on: April 13, 2018
Iliofemoral venous obstruction without thrombosis
R W Harris1, G Andros, L B Dulawa
1Vascular Laboratory, Saint Joseph Medical Center, Burbank, CA 91505.
Journal of Vascular Surgery
|December 1, 1987
Summary
Nonthrombotic iliofemoral venous obstruction can mimic deep vein thrombosis. CT scanning aids diagnosis, enabling specific treatment for venous outflow obstruction.
Area of Science:
- Vascular Surgery
- Radiology
- Oncology
Background:
- Nonthrombotic iliofemoral venous obstruction can present with symptoms similar to deep vein thrombosis (DVT).
- Initial management often involves anticoagulation, which may be inappropriate for nonthrombotic causes.
- Accurate differentiation is crucial for effective treatment and patient outcomes.
Observation:
- Four patients presented with symptoms suggestive of DVT.
- Phlebography showed venous outflow obstruction but no thrombosis.
- Computed tomography (CT) scanning identified the underlying obstructing lesions in all cases.
Findings:
- Surgical interventions included repair of a hypogastric artery aneurysm, resection of an iliac vein leiomyosarcoma, excision of a synovial cyst, and removal of a postherniorrhaphy inflammatory mass.
- Each case involved a distinct nonthrombotic cause of iliofemoral venous obstruction.
- Diagnosis was confirmed through surgical exploration and biopsy.
Implications:
- CT scanning of the abdomen and pelvis should be considered in suspected iliofemoral vein thrombosis cases.
- Integrating CT imaging with traditional methods improves diagnostic accuracy for venous outflow obstruction.
- Specific diagnosis leads to targeted therapies, improving patient management beyond standard DVT treatment.
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