A case of femoral vein thrombosis is described by 3D spiral CT

CAGGIATI, Alberto

CATALANO, Carlo

English

Archivio della ricerca- Università di Roma La Sapienza

images in clinical medicineTh e  n e w  e ngl a nd  j o u r na l  o f  m e dic i n en engl j med 360;11 nejm.org march 12, 2009e16A 56-year-old man presented with a post-thrombotic syndrome of the left leg (involving edema, varicose veins, trophic skin changes, and an ulcer, 5 cm in diameter, of the distal medial leg), resulting from deep-vein throm-bosis 2 years earlier. He had been found to have the factor V Leiden mutation and began receiving maintenance therapy with anticoagulants. Preoperative computed tomography of the leg was used to examine the superficial and deep venous systems, after the images were reformatted to eliminate the subcutaneous fat (Panel A) and muscles (Panels B and C, and see the video). The upper portion of the femoral vein was found to be occluded (Panel B, arrow). Distally, the femoral vein appeared to be duplicated, with the two branches forming an irregular plexus around the femo-ral artery (Panel C, arrowheads). Because of the persistence of the occlusion, no val-vular reconstruction could be performed in the deep veins, and the main varicose trunks could not be surgically repaired. To improve healing and drainage from the ulcerated, dystrophic area of the skin, the distal varicosities were resected, and med-icated compressive bandages were applied. The ulcer healed after 4 weeks, and the symptoms improved considerably. The patient has done well subsequently, receiving maintenance anticoagulant therapy and wearing compression stockings.Copyright © 2009 Massachusetts Medical Society.Venous Obstruction of the ThighAlberto Caggiati, M.D. Carlo Catalano, M.D.Sapienza University of Rome 00161 Rome, Italy alberto.caggiati@uniroma1.it39p6AUTHORFIGUREJOB: ISSUE:4-CH/TRETAKE 1st2ndSIZEICMCASEEMail LineH/TCo boRevisedAUTHOR, PLEASE NOTE: Figure has been redrawn and type has been reset.Please check carefully.REG FFILLTITLE3rdEnon ARTIST:Caggiati  a-c3-12-09mst36011A B CCopyright © 2009 Massachusetts Medical Society. All rights reserved. Downloaded from www.nejm.org at UNIV STUDI ROMA LA SAPIENZA on March 13, 2009 . 

Venous obstruction of the thigh

https://iris.uniroma1.it/bitstream/11573/102919/1/Caggiati_Venous_2009.pdf

Venous obstruction of the thigh

Abstract

Similar works

Full text

Available Versions

Archivio della ricerca- Università di Roma La Sapienza