[Thrombosis of the pelvic and leg--conservative procedure or thrombolytic therapy?]. / Becken-Beinvenenthrombose--konservatives Vorgehen oder Lysetherapie?

ABSTRACT

HISTORY AND ADMISSION FINDINGS: We report on a young female patient with flank pain and a swelling of the lower limb of the left side. INVESTIGATIONS In magnetic resonance angiography as well as Doppler-duplex ultrasound an iliofemoral phlebothrombosis of the left side due to vena cava inferior hypoplasia with collateral circulation was diagnosed. Oral contraception could play a role as a trigger. The patient also presented activated protein C resistance/ heterozygous factor V Leiden mutation. DIAGNOSIS, TREATMENT AND COURSE According to the CaVenT study we treated the patient successfully with catheter-directed thrombolysis. Follow-ups presented a patency of the iliofemoral vein. CONCLUSIONS: In young patients with short duration of a proximal deep vein thrombosis and after exclusion of contraindications a catheter-directed lysis should be considered as a treatment option. The differential diagnostic of a (bilateral) ilio-femoral vein thrombosis in young patients should include an anomaly of the venous system.