{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T09:22:41Z","timestamp":1778923361133,"version":"3.51.4"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Phlegmasia cerulea dolens is a rare manifestation of massive deep vein thrombosis with threat to limb and life. A patient with a background of ovarian malignancy in remission and pelvic radiotherapy presented with left lower limb phlegmasia cerulea dolens as a result of extensive acute left lower limb deep vein thrombosis, extending from the popliteal vein to the inferior vena cava. While initial rapid thrombolysis and left iliac vein stenting were successful, she developed significant hemorrhagic complications from her right radial intra-arterial line with compartment syndrome requiring fasciotomy. She subsequently develops contralateral right lower limb deep vein thrombosis with phlegmasia cerulea dolens as a result of the cessation of anticoagulation and \u2018jailing\u2019 of the contralateral right iliac vein. Repeat thrombolysis with a lower dose of thrombolytics was performed, and contralateral iliac vein stenting in \u2018kissing\u2019 configuration was performed successfully. We discuss several lessons learned from this uncommon but important case.<\/jats:p>","DOI":"10.1093\/jscr\/rjae773","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T13:27:11Z","timestamp":1734010031000},"source":"Crossref","is-referenced-by-count":2,"title":["Lessons learned from a case of phlegmasia cerulea dolens treated with thrombolysis and iliac vein stenting"],"prefix":"10.1093","volume":"2024","author":[{"given":"Adrian C K","family":"Chia","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Singapore General Hospital , Academia Level, Outram Rd ,","place":["Singapore"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1161-5265","authenticated-orcid":false,"given":"Junette","family":"Yu","sequence":"additional","affiliation":[{"name":"Duke-NUS Medical School, Singapore General Hospital , Outram Rd 169608 ,","place":["Singapore"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaun Q W","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Singapore General Hospital , Academia Level, Outram Rd ,","place":["Singapore"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick Z P","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Singapore General Hospital , Academia Level, Outram Rd ,","place":["Singapore"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"key":"2024121213265236300_ref1","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1002\/ccd.25671","article-title":"Role of endovascular stenting in radiation-induced stenosis of lower extremity veins","volume":"86","author":"Elias","year":"2015","journal-title":"Catheter Cardiovasc Interv"},{"key":"2024121213265236300_ref2","doi-asserted-by":"publisher","first-page":"865","DOI":"10.3949\/ccjm.83a.15166","article-title":"Phlegmasia cerulea dolens from radiation-induced venous stenosis","volume":"83","author":"Paul","year":"2016","journal-title":"Cleve Clin J Med"},{"key":"2024121213265236300_ref3","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1006\/gyno.1995.1064","article-title":"Management of pelvic venous stenosis with intravascular stainless steel stents","volume":"56","author":"Carlson","year":"1995","journal-title":"Gynecol Oncol"},{"key":"2024121213265236300_ref4","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.jvs.2004.03.039","article-title":"Radiation-associated venous stenosis: endovascular treatment options","volume":"40","author":"Zhou","year":"2004","journal-title":"J Vasc Surg"},{"key":"2024121213265236300_ref5","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1093\/icvts\/ivy146","article-title":"Kissing stents for radiation-induced bilateral common iliac vein stenosis","volume":"27","author":"Lee","year":"2018","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2024121213265236300_ref6","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1016\/j.jvir.2015.01.036","article-title":"Endovascular Management of Deep Vein Thrombosis with Rheolytic thrombectomy: final report of the prospective Multicenter PEARL (peripheral use of AngioJet Rheolytic thrombectomy with a variety of catheter lengths) registry","volume":"26","author":"Garcia","year":"2015","journal-title":"J Vasc Interv Radiol"},{"key":"2024121213265236300_ref7","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.avsg.2018.11.017","article-title":"The efficacy and safety of AngioJet Rheolytic thrombectomy in the treatment of subacute deep venous thrombosis in lower extremity","volume":"58","author":"Song","year":"2019","journal-title":"Ann Vasc Surg"},{"key":"2024121213265236300_ref8","doi-asserted-by":"publisher","first-page":"S228","DOI":"10.21037\/cdt.2017.09.15","article-title":"Catheter-directed thrombolysis of deep vein thrombosis: literature review and practice considerations","volume":"7","author":"Fleck","year":"2017","journal-title":"Cardiovasc Diagn Ther"},{"key":"2024121213265236300_ref9","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1016\/j.jvsv.2019.03.015","article-title":"A comparison between intravascular ultrasound and venography in identifying key parameters essential for iliac vein stenting","volume":"7","author":"Montminy","year":"2019","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"key":"2024121213265236300_ref10","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1177\/0268355520946219","article-title":"Use of the VENOVO\u2122 and sinus obliquus\u2122 venous stents in the treatment of non-thrombotic or post-thrombotic iliac vein lesions - 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