[Thrombosis of the pelvic and leg--conservative procedure or thrombolytic therapy?].

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.