22 year old with severe post thrombotic syndrome 6 months after left leg deep venous thrombosis (DVT). Initial attempt at catheter directed thrombolysis without iliac vein stenting resulted in re-thrombosis. The patient had severe restriction in activity due to venous claudication and he wanted to see if anything could be done. He underwent stenting and venoplasty of the left common and external iliac veins. There was marked improvement in leg swelling and leg pain. However, the changes from the original DVT in the femoral and popliteal veins have left him with persistent swelling and discomfort.
64 year old male, type 1 diabetes, with a prior femoral to politeal bypass graft and a subsequent poplileal to tibial bypass graft.
51 year old female with a long history of low back pain, pelvic aching and heaviness, urinary frequency and painful intercourse.
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.