PMC9626237_01
(a, b, c) CT abdomen/pelvis with contrast significant for occlusive thrombus in visualized portions of deep femoral veins, extending into the left common femoral vein, and into the left external, internal, and common iliac veins.
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fig2
CTA abdomen/pelvis showed occlusive thrombus in visualized portions of left superficial and deep femoral veins, extending into the left common femoral vein, and into the left external, internal, and common iliac veins, with compression of the left common iliac vein by the crossing right common iliac artery, findings were suggestive of MTS (Figure 2).
(a) CT abdomen/pelvis with contrast showing intrahepatic IVC stenosis (blue arrow). (b) Seen is a large diaphragmatic venous collateral to the IVC (orange arrow), indicating that the thrombosis in this patient was acute on chronic pathology.
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fig3
CTA abdomen/pelvis also showed an unusually narrow inferior vena cava (IVC) indicative of intrahepatic IVC stenosis (Figure 3(a)), with multiple intra-abdominal collaterals (Figure 3(b)).
Venogram seen above displaying a "tram-track pattern", which is significant for DVT in the stenosed vein.
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fig4
The patient underwent a left lower extremity venogram by the IR team which showed an occluded left popliteal vein extending up to the left external iliac vein with a tram-track pattern (Figure 4).