Phlegmasia cerulea dolens: therapeutic considerations.

摘要: Phlegmasia cerulea dolens (PCD) is a rare venous disorder that continues to be major therapeutic challenge. We reviewed 16 cases of PCD treated during the past 15 years; 11 patients were male, and average age all was 59 years. Malignant disease most common underlying condition (seven patients). Venous gangrene (VG) present in seven extremities. Three treatment methods used alone or combination--intravenous heparin, thrombectomy, thrombolytic therapy. Heparin initially 13 patients; it yielded successful result (53%) patients, none whom had VG. thrombectomy done six three primary procedure, two followed failure one both heparin (50%) early Thrombolytic therapy on occasion conjunction with without benefit. Five died, VG, after only, methods. Review 38 reported recent literature shows comparable results. These data suggest nongangrenous forms respond well systemic anticoagulation. Combination using indicated for severe ischemia, improve 12 hours VG lethal form entity responds poorly established Future trials need consider aggressive use thrombolysis thrombectomy.