PMC5603125_01
Thrombotic occlusion of femoral vein (patient in prone position).
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After successful cannulating the popliteal vein, contrast injection showed totally thrombotic occlusion of left common femoral and iliac veins but obviously patent IVC (Figure 1).
Follow-up venography revealed dramatic resolution of clot burden.
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In the following day, the patient was brought back to angiography laboratory to perform follow-up venography which revealed dramatic resolution of clot burden and nice penetration of contrast toward patent IVC (Figure 2).
Leakage out of caveofemoral junction extensively.
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fig3
During catheter passage and wire exchange, before deploying of stent, unfortunately we encountered leakage out of caveofemoral junction (the distal edge of IVC) extensively (Figure 3).
Unsuccessful result of balloon inflations forced us to decide to reverse anticoagulant condition of our patient (supine position).
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Unsuccessful result of balloon inflations which was showed in subsequent injections (Figure 4) forced us to decide to reverse anticoagulant condition of our patient (due to alteplase and heparin infusion).
Final result of procedure.
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Fortunately, this courageous strategy in spite of fear of stent thrombosis and even our patient primary pathology itself (acute thrombosis) causes leakage to diminish significantly and in following balloon inflations to stop completely (Figure 5).
Follow-up CT scan showed patent iliac vein stent.
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Although the next day pelvic and abdominal CT angiography showed the extent of patient bleeding and of course patent iliac vein stent (Figure 6), she passed an uneventful course in following days of admission.