+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Compartment syndrome in patients with massive venous thrombosis after inferior vena cava filter placement



Compartment syndrome in patients with massive venous thrombosis after inferior vena cava filter placement



Orthopedics 34(3): 229



Massive venous thrombosis, which can occur acutely after inferior vena cava filter placement, has 2 forms: phlegmasia cerulea dolens and phlegmasia alba dolens. In phlegmasia cerulea dolens, complete occlusion of venous outflow occurs. In the milder phlegmasia alba dolens version, collateral venous flow out of the limb remains despite the venous thrombosis. This article presents, to our knowledge, the first 2 cases of massive venous thrombosis (1 phlegmasia cerulea dolens, 1 phlegmasia alba dolens) below inferior vena cava filters occurring after the acute period. Phlegmasia cerulea dolens and phlegmasia alba dolens can present as compartment syndrome. Prompt fasciotomies were performed, but the underlying massive venous thrombosis was not addressed surgically. Phlegmasia cerulea dolens and phlegmasia alba dolens have high morbidity and mortality. The patient with phlegmasia alba dolens required leg and thigh fasciotomies and eventually required an above-knee amputation. The patient with phlegmasia cerulea dolens developed compartment syndrome in the left leg, right leg, and right thigh. Although he underwent decompression of all of these compartments, he died from multiple organ failure. A multidisciplinary approach with the vascular service and the intensivists is required in the treatment of patients with massive venous thrombosis. Treatment goals include preventing additional propagation of the thrombus via anticoagulation, with strong consideration for catheter-directed thrombolysis or thrombectomy and fasciotomies for compartment syndrome. The orthopedic surgeon should keep phlegmasia cerulea dolens and phlegmasia alba dolens in the differential for compartment syndrome, especially in patients who have had a history of acute or chronic inferior vena cava filter placement.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 052252051

Download citation: RISBibTeXText

PMID: 21410121


Related references

Heparin-induced thrombocytopenia complicated with massive thrombosis of the inferior vena cava after filter placement. International Angiology 24(4): 387-390, 2005

Treatment of superior vena cava (SVC) syndrome and inferior vena cava (IVC) thrombosis in a patient with colorectal cancer: combination of SVC stenting and IVC filter placement to palliate symptoms and pave the way for port implantation. Cardiovascular and Interventional Radiology 31 Suppl 2: S144-S148, 2007

Bilateral compartment syndrome as a result of inferior vena cava filter thrombosis. Annals of Emergency Medicine 52(2): 104-107, 2007

Placement of a retrievable inferior vena cava filter for deep venous thrombosis in term pregnancy. Journal of Vascular Surgery 55(4): 1042-1047, 2012

Inferior vena cava filter placement during thrombolysis for acute iliofemoral deep venous thrombosis. Journal of Vascular Surgery. Venous and Lymphatic Disorders 2(3): 274-281, 2014

Evaluation of nonpermanent inferior vena cava filter placement in patients with deep venous thrombosis after lower extremity fracture: A single-center retrospective study. Phlebology 31(8): 564-572, 2018

Gunther tulip inferior vena cava filter placement during treatment for deep venous thrombosis of the lower extremity. Cardiovascular and Interventional Radiology 28(4): 442-453, 2005

Heparin-induced thrombocytopenia in a glioblastoma multiforme patient with inferior vena cava filter placement for deep venous thrombosis. Neurologia Medico-Chirurgica 51(6): 445-448, 2011

Prophylactic Placement of an Inferior Vena Cava Filter During Aspiration Thrombectomy for Acute Deep Venous Thrombosis of the Lower Extremity. Vascular and Endovascular Surgery 50(4): 270-276, 2017

Acute vena cava thrombosis after placement of retrievable inferior vena cava filter before laparoscopic gastric bypass. Surgery for Obesity and Related Diseases 2(6): 661-663, 2006

Prophylactic inferior vena cava (IVC) filter placement may increase the relative risk of deep venous thrombosis after acute spinal cord injury. Journal of Trauma 66(3): 707-712, 2009

Inferior Vena Cava Filter Placement in Patients with Venous Thromboembolism without Contraindication to Anticoagulation. Journal of Hospital Medicine 13(10): 719-721, 2018

Application of suprarenal inferior vena cava filter placement in patients with venous thromboembolism. Zhonghua Yi Xue Za Zhi 95(25): 1997-1999, 2016

Long-term outcomes of catheter directed thrombolysis for lower extremity deep venous thrombosis without prophylactic inferior vena cava filter placement. Journal of Vascular Surgery 45(5): 992-7; Discussion 997, 2007

Optimal cytoreductive surgery for underlying ovarian cancer associated with deep venous thrombosis without placement of inferior vena cava filter: A case report and literature review. Oncology Letters 10(4): 2579-2583, 2015