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Endovascular Treatment in a Case of Phelgmasia Cerulean Doleans

Background: Phlegmasia cerulean dolens (PCD) is an uncommon and severe manifestation of massive 
proximal venous thrombosis of the lower extremities associated with a high degree of morbidity and 
mortality. 
Case: We describe a case of a 67-year-old gentleman with metastatic gastric neuroendocrine tumour, who 
developed PCD of his left lower limb. He underwent endovascular thrombectomy with thrombolysis and 
stent placement with good effect. 
Discussion: Characterised by severe venous outflow obstruction, marked limb swelling, pain and 
discolouration, PCD can lead to venous gangrene, congestion with massive fluid sequestration and 
circulatory collapse if left untreated. Various treatment modalities were reported with varying outcomes, 
morbidity and mortality. 
Conclusion: A multifaceted approach to PCD may be required for successful limb salvage, taking into 
account the risks and benefits of each treatment modality.