[No surgery without previous compression ultrasound in patients with a superficial venous thrombosis: a case of massive paradoxical embolism]

Abstract

Lower limbs superficial venous thrombosis (LLSVT) is usually considered as common and of a benign prognosis. LLSVT can, however, be responsible for major thromboembolic complications: lower limbs deep vein thrombosis (LLDVT) and pulmonary embolism (PE). We report a case of a LLSVT complicated with a massive bilateral PE and an ischemic cerebral stroke, occurring immediately after a varicose vein surgery. Venous ultrasonography of the lower limbs must be systematically performed in case of LLSVT, in order to evaluate the presence of an associated LLDVT. A rigorous diagnostic and therapeutic approach is the only way to optimize the treatment of this disorder, and to avoid the occurrence of dramatic venous thromboembolic complications.

Keywords: Accident vasculaire cérébral ischémique; Embolie pulmonaire; Foramen ovale perméable; Ischemic cerebral stroke; Patent foramen oval; Pulmonary embolism; Stripping de varices; Superficial venous thrombosis; Thrombose veineuse superficielle; Varicose surgery.