Interventional therapy of a descending ilio-femoral deep vein thrombosis in a young women

Summary

We report the case of a 15 year old girl presenting with a descending left ilio-femoral deep vein thrombosis associated with an iliocaval vein abnormality. After a first unsuccessful thrombectomy, the patient was referred to a specialized centre and treated with a combined approach consisting of thrombectomy, thrombolysis, stenting, and a temporary AV–fistula. At the 5-year follow-up visit, the young lady was free of symptoms with no clinical signs of a postthrombotic syndrome. Duplex ultrasound and plethysmography were normal.

The opportunity of an interventional treatment of an iliofemoral DVT in a young person should be contemplated more often than it is currently done. The eventual presence of a vascular anomaly or anatomical variant should be sought and corrected. About two thirds of patients with a descending iliofemoral DVT are candidates for a curative treatment.

English version available at: www.phlebologieonline.de

Keywords

Ilio-femoral deep vein thrombosis - thrombectomie - thrombolysis

• Literatur

• 1 Blättler W, Heller G, Largiadèr J. et al. Combined regional thrombolysis and surgical thrombectomy for treatment of iliofemoral vein thrombosis. J Vasc Surg 2004; 40: 620-625.
• 2 Baekgaard N, Broholm R, Just S. et al. Longterm results using catheter-directed thrombolysis in 103 limbs with acute iliofemoral venous thrombosis. Eur J Vasc Endovasc Surg 2010; 39: 112-117.
• 3 Karthikesalingam A, Young EL, Hinchliffe RJ. et al. A systematic review of percutaneous mechanical thrombectomy in the treatment of deep venous thrombosis. Eur J Vasc Endovasc Surg 2011; 41: 554-565.
• 4 Gauci BN, Powell JT, Hunt BJ. et al. The feasibility of catheter-directed thrombolysis for acute deep vein thrombosis: a regional perspective. Phlebology 2011; 26: 94-101.
• 5 Enden T, Haig Y, Kløw NE. et al. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet 2012; 379: 31-38.
• 6 Hofmann LV, Kuo WT. Catheter-directed thrombolysis for acute DVT. Lancet 2012; 379: 3-4.