case_images: PMC10235677_01
case_images: A 34-year-old female with cervical cancer developed left lower limb edema one year following surgery and pelvic radiation therapy. After administration, the pelvic MRI indicated no evidence of cancer recurrence or extrinsic compression, and left thigh subcutaneous tissue edema was observed (white arrow).
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case_images: After her admission to our clinic, the pelvic MRI revealed no indications of cancer recurrence or extrinsic compression, and left thigh subcutaneous tissue swelling was observed (Figure 1).
case_images: (A), Venogram demonstrated significant stenosis of the left proximal external iliac vein (black arrow) and mild stenosis of the proximal common iliac vein (white arrow). (B) Significant recoil of stenosis of the external iliac vein after dilatation (black arrow). (C) Extravasation at the site of external iliac vein stenosis (black arrow) following post dilatation of the Venovo stent (white arrow). (D) The final venogram revealed that the covered stent (white arrow) was implanted inside the Venovo stent (black arrow) to stop the bleeding.
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case_images: Tokyo, Japan) was inserted into the left common femoral vein to perform a venogram with multiple projections observation. This revealed significant stenosis of the left proximal external iliac vein (EIV) and mild stenosis of the proximal common iliac vein (CIV) at the Iliocaval confluence (Figure 2A). The venogram with multiple projections indicated the significant recoil of EIV stenosis after dilatation (Figure 2B). The quick angiogram revealed extravasation at the site of EIV stenosis (Figure 2C), and the balloon was inserted and inflated to 4 atm to stop extravasation. A 13.5 x 60 mm self-expanding covered stent (Fluency Plus stent graft, Bard, Karlsruhe, Germany) was implanted into the vein stent, with the proximal end just 1 cm beyond the Venovo stent (Figure 2D).
case_images: Three days after the procedure, a CT scan revealed retroperitoneal hematoma and blood and fluid accumulation in the abdominopelvic cavity. (white arrow).
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case_images: On the third postoperative day, her hemoglobin level rose to 94 g/L, and a computed tomography (CT) scan revealed retroperitoneal hematoma and blood and fluid accumulation in the abdominopelvic cavity (Figure 3).