Abood Zaid, Jan M Fuad, Weiss Eric S, Bajwa Tanvir, Allaqaband Suhail Q, Mewissen Mark W
Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Aurora Health Care, Milwaukee, WI, United States.
Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Milwaukee Clinical Campus, Milwaukee, WI, United States.
Front Cardiovasc Med. 2025 May 16;12:1568102. doi: 10.3389/fcvm.2025.1568102. eCollection 2025.
Transcatheter tricuspid valve intervention (TTVI) has evolved as a less-invasive alternative to surgical treatment of severe tricuspid regurgitation. Although venously delivered valves have been introduced, the risk of venous access site complications is unknown. We present a patient who suffered phlegmasia cerulea dolens post-TTVI.
We present an 88-year-old female patient who developed phlegmasia cerulea dolens of the right lower extremity shortly after successful TTVI delivered through the right common femoral vein via a 35F sheath. Ipsilateral transpopliteal venography demonstrated an occlusive thrombus in the right common femoral vein and the incidental finding of an external iliac vein pseudoaneurysm. Endovascular treatment consisting of mechanical thrombectomy followed by adjunctive placement of self-expanding metallic stents resulted in restoration of iliofemoral venous outflow and excellent recovery with resolution of the patient's symptoms.
Surveillance, e.g., duplex ultrasonography, immediately post-TTVI is important to rule out acute thrombosis of the venous access site and other complications associated with a large sheath.
经导管三尖瓣介入治疗（TTVI）已发展成为一种侵入性较小的严重三尖瓣反流手术治疗替代方法。尽管已经引入了经静脉输送的瓣膜，但静脉入路部位并发症的风险尚不清楚。我们报告一例TTVI术后发生股青肿的患者。
我们报告一名88岁女性患者，通过35F鞘经右股总静脉成功进行TTVI后不久，出现右下肢股青肿。同侧经腘静脉造影显示右股总静脉有闭塞性血栓形成，并意外发现髂外静脉假性动脉瘤。血管内治疗包括机械性血栓清除术，随后辅助置入自膨式金属支架，恢复了髂股静脉流出道，患者症状消退，恢复良好。
TTVI术后立即进行监测，如双功超声检查，对于排除静脉入路部位急性血栓形成及与大鞘相关的其他并发症很重要。
