{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T09:21:42Z","timestamp":1778923302580,"version":"3.51.4"},"reference-count":12,"publisher":"Texas Heart Institute Journal","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022]]},"abstract":"Phlegmasia cerulea dolens, a rare and potentially fatal complication of acute deep vein thrombosis, is characterized by substantial edema, intense pain, and cyanosis. Phlegmasia cerulea dolens may compromise limb perfusion and lead to acute ischemia, gangrene, amputation, and death. We present the case of a 61-year-old woman with a history of breast cancer who had signs and symptoms of phlegmasia cerulea dolens in her left leg. She was treated promptly with open surgical thrombectomy and sequential distal compression with use of an Esmarch bandage to ensure complete thrombus extraction. These techniques restored venous flow and saved her leg. Open surgical thrombectomy should be considered in the presence of limb-threatening acute deep vein thrombosis presenting as phlegmasia cerulea dolens.<\/jats:p>","DOI":"10.14503\/thij-20-7400","type":"journal-article","created":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T14:57:34Z","timestamp":1643641054000},"source":"Crossref","is-referenced-by-count":3,"title":["Surgical Intervention for Phlegmasia Cerulea Dolens in a 61-Year-Old Cancer Patient"],"prefix":"10.14503","volume":"49","author":[{"given":"Christopher","family":"Ruben-Castillo","sequence":"first","affiliation":[{"name":"Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar","family":"Cuen-Ojeda","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Lopez-Pe\u00f1a","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier E.","family":"Anaya-Ayala","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos A.","family":"Hinojosa","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5628","reference":[{"issue":"8","key":"i1526-6702-49-1-e207400-b1","series-title":"Pharmacotherapy","first-page":"943","article-title":"Economic burden of venous thromboembolism in hospitalized patients","volume":"29","year":"2009","unstructured":"Dobesh\n PP.\n \n \n Economic burden of venous thromboembolism in hospitalized patients.\n\t\t\t\t\tPharmacotherapy2009;29(8):943\u201353."},{"issue":"3","key":"i1526-6702-49-1-e207400-b2","series-title":"Ann Vasc Dis","first-page":"355","article-title":"Phlegmasia cerulea dolens with compartment syndrome","volume":"11","year":"2018","unstructured":"Chaochankit\n W,\n \n \n Akaraborworn\n O.\n \n \n Phlegmasia cerulea dolens with compartment syndrome.\n\t\t\t\t\tAnn Vasc Dis2018;11(3):355\u20137."},{"issue":"2","key":"i1526-6702-49-1-e207400-b3","series-title":"J Vasc Surg Cases Innov Tech","first-page":"212","article-title":"Effective single-session percutaneous nonpharmacologic mechanical thrombectomy for phlegmasia cerulea dolens","volume":"6","year":"2020","unstructured":"Mouawad\n NJ.\n \n \n Effective single-session percutaneous nonpharmacologic mechanical thrombectomy for phlegmasia cerulea dolens.\n\t\t\t\t\tJ Vasc Surg Cases Innov Tech2020;6(2):212\u20135."},{"issue":"10","key":"i1526-6702-49-1-e207400-b4","series-title":"J Vasc Interv Radiol","first-page":"1001","article-title":"Lower extremity venous thrombolysis with adjunctive mechanical thrombectomy","volume":"13","year":"2002","unstructured":"Vedantham\n S,\n \n \n Vesely\n TM,\n \n \n Parti\n N,\n \n \n Darcy\n M,\n \n \n Hovsepian\n DM,\n \n \n Picus\n D.\n \n \n Lower extremity venous thrombolysis with adjunctive mechanical thrombectomy.\n\t\t\t\t\tJ Vasc Interv Radiol2002;13(10):1001\u20138."},{"issue":"6","key":"i1526-6702-49-1-e207400-b5","series-title":"Am J Surg","first-page":"782","article-title":"Catheter-direct thrombolysis versus pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis","volume":"192","year":"2006","unstructured":"Lin\n PH,\n \n \n Zhou\n W,\n \n \n Dardik\n A,\n \n \n Mussa\n F,\n \n \n Kougias\n P,\n \n \n Hedayati\n N,\n \n \n .\n\t\t\t\t\tCatheter-direct thrombolysis versus pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis.\n\t\t\t\t\tAm J Surg2006;192(6):782\u20138."},{"issue":"1","key":"i1526-6702-49-1-e207400-b6","series-title":"Tex Heart Inst J","first-page":"76","article-title":"Phlegmasia cerulea dolens","volume":"36","year":"2009","unstructured":"Sarwar\n S,\n \n \n Narra\n S,\n \n \n Munir\n A.\n \n \n Phlegmasia cerulea dolens.\n\t\t\t\t\tTex Heart Inst J2009;36(1):76\u20137."},{"issue":"4","key":"i1526-6702-49-1-e207400-b7","series-title":"J Thromb Thrombolysis","first-page":"458","article-title":"Rates of symptomatic venous thromboembolism in US surgical patients: a retrospective administrative database study","volume":"28","year":"2009","unstructured":"Spyropoulos\n AC,\n \n \n Hussein\n M,\n \n \n Lin\n J,\n \n \n Battleman\n D.\n \n \n Rates of symptomatic venous thromboembolism in US surgical patients: a retrospective administrative database study.\n\t\t\t\t\tJ Thromb Thrombolysis2009;28(4):458\u201364."},{"issue":"1","key":"i1526-6702-49-1-e207400-b8","series-title":"Vasc Endovascular Surg","first-page":"5","article-title":"Trends in management of phlegmasia cerulea dolens","volume":"45","year":"2011","unstructured":"Chinsakchai\n K,\n \n \n Ten Duis\n K,\n \n \n Moll\n FL,\n \n \n de Borst\n GJ.\n \n \n Trends in management of phlegmasia cerulea dolens.\n\t\t\t\t\tVasc Endovascular Surg2011;45(1):5\u201314."},{"issue":"1","key":"i1526-6702-49-1-e207400-b9","series-title":"Ann Vasc Dis","first-page":"45","article-title":"Management of bilateral phlegmasia cerulea dolens in a patient with subacute splenic laceration","volume":"1","year":"2008","unstructured":"Bazan\n HA,\n \n \n Reiner\n E,\n \n \n Sumpio\n B.\n \n \n Management of bilateral phlegmasia cerulea dolens in a patient with subacute splenic laceration.\n\t\t\t\t\tAnn Vasc Dis2008;1(1):45\u20138."},{"key":"i1526-6702-49-1-e207400-b10","series-title":"Ann Vasc Surg","first-page":"314","article-title":"Acute venous iliofemoral thrombosis: early surgical thrombectomy is effective and durable","volume":"46","year":"2018","unstructured":"Ockert\n S,\n \n \n von Allmen\n M,\n \n \n Heidemann\n M,\n \n \n Brusa\n J,\n \n \n Duwe\n J,\n \n \n Seelos\n R.\n \n \n Acute venous iliofemoral thrombosis: early surgical thrombectomy is effective and durable.\n\t\t\t\t\tAnn Vasc Surg2018;46:314\u201321."},{"issue":"4","key":"i1526-6702-49-1-e207400-b11","series-title":"Eur J Vasc Endovasc Surg","first-page":"554","article-title":"A systematic review of percutaneous mechanical thrombectomy in the treatment of deep venous thrombosis","volume":"41","year":"2011","unstructured":"Karthikesalingam\n A,\n \n \n Young\n EL,\n \n \n Hinchliffe\n RJ,\n \n \n Loftus\n IM,\n \n \n Thompson\n MM,\n \n \n Holt\n PJE.\n \n \n A systematic review of percutaneous mechanical thrombectomy in the treatment of deep venous thrombosis.\n\t\t\t\t\tEur J Vasc Endovasc Surg2011;41(4):554\u201365."},{"issue":"3","key":"i1526-6702-49-1-e207400-b12","series-title":"Orthopedics","first-page":"229","article-title":"Compartment syndrome in patients with massive venous thrombosis after inferior vena cava filter placement","volume":"34","year":"2011","unstructured":"Mesfin\n A,\n \n \n Lum\n YW,\n \n \n Nayfeh\n T,\n \n \n Mears\n SC.\n \n \n Compartment syndrome in patients with massive venous thrombosis after inferior vena cava filter placement.\n\t\t\t\t\tOrthopedics2011;34(3):229."}],"container-title":["Texas Heart Institute 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