A case report of inadequately treated acute deep venous thrombus and venous stasis

Venous stasis dermatitis is a common skin condition that typically affects the lower extremities and may occur secondarily to venous insufficiency which can lead to a pooling of fluid within the legs. The etiology of venous stasis dermatitis is largely related to medical conditions that affect the blood flow to the lower extremities. Chronic occlusion of the common iliac veins and femoral veins can cause a lack of proper blood flow to the lower extremities. When an inferior vena cava (IVC) filter becomes tilted, it can occlude the vessels distal to its placement. Definitive treatment of chronic venous insufficiency is not common and could be improved with a referral to an interventional radiologist.

Here, we present a case of a venous stasis that is presenting secondary to chronic occlusion of the left common iliac vein and femoral vein due to a tilted and irretrievable IVC filter that was placed more than 5 years prior to presentation. Upon presentation, the patient was unable to ambulate and was suffering from large lower leg ulcers and chronic venous insufficiency secondary to the occluded vessels. The patient was treated with a series of thrombectomies in an outpatient setting until the restoration of venous blood flow was achieved. The improved venous blood flow has reduced the painful leg ulcers both in number and severity-which greatly reduces the patient's likelihood of a secondary infection.

This case emphasizes the importance of an interdisciplinary approach to patients who may present to an outpatient dermatology clinic with signs or symptoms of acute or chronic venous insufficiency for a more definitive treatment than the current standard of care.