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Abstract
Deep vein thrombosis (DVT), which usually occurs in the lower extremities, is the presence of a blood clot within a deep vein that causes symptoms by breaking the venous return. Many cases of calf vein DVT are asymptomatic, or display only mild symptoms. But in the case of a proximal DVT, it affects the venous flow through the entire lower extremity, which results in a post-thrombotic syndrome, or a pulmonary embolism, if the proper treatment isn't performed. The diagnosis of the DVT is made by a radiologic examination. An ultrasound is often used as a first line of diagnosis, but on the other hand, computed tomography venography has also been gaining traction as an alternative method. If diagnosed, finding the cause of the DVT is important, and in the case of a symptomatic proximal DVT, the combination of anticoagulation and interventional treatment can be used towards the recovery of the venous return, preventing complications.
References
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Fig. 1.
Ultrasonography of an 89-year-old female with acute deep vein thrombosis in her right leg. A. In color Doppler ultrasonography, there is no flow through the popliteal vein (arrow). B. This vein does not collapse upon compression (arrow).
Fig. 2.
Computed tomography venography of an 84-year-old male patient. There is an abnormal dilated left common femoral vein with hypodense filling defects in the lumen and subtle vascular wall enhancement (arrow). These findings are compatible with an acute stage of deep vein thrombosis. Combined subcutaneous edema is noted.
Fig. 3.
Computed tomography venography of a 71-year-old female patient with a previous history of May-Thurner syndrome 9 years previously. The stent of the left common iliac vein, placed 9 years ago, is occluded (A, arrow). The left external iliac vein is in a near complete obliteration state (B, arrow) and multiple collateral vessels are noted in the subcutaneous layer of anterior lower abdominal wall and pelvic cavity (C, arrows).
Fig. 4.
Acute and chronic DVT in conventional leg ascending venography. A. A 66-year-old female with an acute DVT in her left leg. Multiple filling defects are noted in the femoral and popliteal veins outlining the dilated veins. Femoral vein duplication (arrows) is noted. B. A 63-year-old male with chronic DVT in her right leg. The obliteration of femoral vein with multiple collateral vessels is noted. DVT = deep vein thrombosis
Fig. 5.
Illustration of the catheter directed thrombolysis. The vascular sheath is inserted via the popliteal vein. Through this vascular sheath, a 5-Fr multi-sidehole infusion catheter is inserted with the tip embedded in the thrombus. Through this infusion catheter, a thrombolytic agent is infused. An anticoagulant is infused via the both of side arm of the vascular sheath and other peripheral intravenous line.
Table 1.
Risk Factors of the Development of Deep Vein Thrombosis
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