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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2018, Number 1

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Rev Mex Angiol 2018; 46 (1)

¿Debemos abandonar la trombectomía quirúrgica en caso de flegmasia cerúlea dolens en la era endovascular?

Martínez-Martínez J, Sierra-Juárez MA, Lecuona-Huet NE, Moreno-Vargas HC, Farro-Moreno A, Ziga-Martínez A

Language: Spanish
References: 21
Page: 39-43
PDF size: 158.94 Kb.


ABSTRACT

We report a case of phlegmasia cerulean dolens, a form of deep vein thrombosis complicated by arterial ischemia. A 41-year-old male patient went to the emergency department for pain, edema and cyanosis of the left pelvic limb one day evolution. On clinical examination with edema, left lower limb cyanosis with signs of ischemia. Doppler ultrasonography demonstrates thrombus in the iliac and femoral veins. We diagnose phlegmasia cerulean dolens is operated on urgently with venous thrombectomy, evolving favorably. Phlegmasia cerulean dolens is a particular form of deep venous thrombosis is combined with signs of arterial ischemia secondary to massive edema and collapse of arterial flow. Cancer being the most common cause. It should be suspected in the presence of the classic triad pain, edema and cyanosis, with confirmation by Doppler ultrasound. Anticoagulation is the main treatment for this disease. There are two treatment options (endovascular or surgical). In the endovascular era, catheter-directed thrombolysis is the treatment of choice to achieve venous permeability. However, surgical thrombectomy is indicated in certain cases for limb salvage. Early diagnosis and rapid initiation of treatment are essential to improve the prognosis of this severe condition.


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