Surgical Thrombectomy and Simultaneous Stenting for Phlegmasia Cerulea Dolens Caused by Iliac Vein Occlusion

Ann Vasc Surg. 2018 Aug:51:239-245. doi: 10.1016/j.avsg.2018.01.082. Epub 2018 Mar 5.

Abstract

Background: Phlegmasia cerulea dolens (PCD) is a severe complication of deep veions thrombosis, and there are several treatment methods. This study aimed to investigate the clinical efficacy of surgical thrombectomy and simultaneous iliac vein stent implantation for the treatment of PCD caused by iliac vein occlusion.

Purpose: This study aimed to investigate the clinical efficacy of surgical thrombectomy and simultaneous iliac vein stent implantation for the treatment of phlegmasia cerulea dolens (PCD) caused by iliac vein occlusion.

Methods: From February 2014 to December 2016, 5 patients with secondary PCD complicated with iliac vein occlusion were treated in our center. Thrombectomy by venous incision was performed with simultaneous iliac vein balloon dilatation and stents implantation. Efficacy and stents patency were assessed. Iliac vein occlusions were confirmed in all 5 patients by angiography after the thrombectomy. Stents implantation were performed after balloon dilatation. Three stents were implanted in 1 case of iliac vein and inferior vena cava (IVC) occlusion, whereas 1 stent was implanted in each of the other 4 cases.

Results: Symptoms were significantly relieved after surgery, with no complications. Patients were followed up for 6-24 months, and minor swelling of the affected limb was found in 1 case, with no thrombosis recurrence in all cases and vascular stent patency.

Conclusions: Thrombectomy by venous incision and simultaneous iliac vein stent implantation for the treatment of PCD caused by iliac vein occlusion can quickly relieve symptoms, is easily implemented, is associated with fewer complications, and has good midterm efficacy and a high patency rate, making this technique a good treatment method.

MeSH terms

  • Adult
  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / instrumentation*
  • Computed Tomography Angiography
  • Female
  • Humans
  • Iliac Vein / diagnostic imaging
  • Iliac Vein / physiopathology
  • Iliac Vein / surgery*
  • Male
  • Middle Aged
  • Phlebography / methods
  • Stents*
  • Thrombectomy* / adverse effects
  • Thrombophlebitis / diagnostic imaging
  • Thrombophlebitis / etiology
  • Thrombophlebitis / physiopathology
  • Thrombophlebitis / therapy*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency
  • Venous Thrombosis / complications
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / physiopathology
  • Venous Thrombosis / therapy*