• Ramsey A Al-Hakim, Alexander Boscanin, David D Prosser, and John A Kaufman.
• Dotter Department of Interventional Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA. alhakim@ohsu.edu.
• Cardiovasc Intervent Radiol. 2020 Sep 1; 43 (9): 1398-1401.

AbstractAdvanced cases of phlegmasia cerulea dolens (PCD) with absent pedal pulses, sensory/motor deficits, and/or venous gangrene likely require more rapid restoration of flow compared to cases without these factors to prevent progression and associated morbidity/mortality. We present a case of PCD with absent pedal pulses and sensory deficit managed successfully with emergent percutaneous mechanical thrombectomy using Inari ClotTriever (Inari Medical, Irvine, CA) with immediate clinical resolution, including restoration of pedal pulses ~ 45 min after thrombectomy. Percutaneous mechanical thrombectomy with the ClotTriever device has the ability to immediately restore venous flow reversing the pathophysiology of PCD in a short time period similar to surgical embolectomy and may be an alternative treatment strategy in patients with phlegmasia cerulea dolens of high severity.

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