72 year old male patient with 3 left lower extremity DVT's. Patient was developing severe post thrombotic syndrome (PTS). The patient was positive for Lupus anticoagulant was being treated with oral anticoagulation. Apart from a lower extremity venous ultrasound no investigation of the pelvic venous system was done. Imaging of the venous outflow in the abdomen and pelvis showed severe compression of the left external iliac vein. Intravascular ultrasound confirmed the compression and treatment with stenting and venoplasty was performed. The patients symptoms of PTS improved. Had the patient been treated earlier, they would have a better long term outcome. Patients with recurrent DVT or with unprovoked DVT should be evaluated for iliac vein compression.
86 year old female with a several month history of a painful non-healing ulcer over the lateral malleolus.
64 year old female with severe short distance claudication limiting the patients ability to work
Short distance claudication and rest pain secondary to thrombosed popliteal artery aneurysm treated endovasculary.