case_images: PMC5603125_01
case_images: Thrombotic occlusion of femoral vein (patient in prone position).
case_images: CRIVAM2017-3746815.001.jpg
case_images: PMC5603125_01_CRIVAM2017-3746815.001.jpg
case_images: fig1
case_images: After successful cannulating the popliteal vein, contrast injection showed totally thrombotic occlusion of left common femoral and iliac veins but obviously patent IVC (Figure 1).
case_images: Follow-up venography revealed dramatic resolution of clot burden.
case_images: CRIVAM2017-3746815.002.jpg
case_images: PMC5603125_01_CRIVAM2017-3746815.002.jpg
case_images: fig2
case_images: In the following day, the patient was brought back to angiography laboratory to perform follow-up venography which revealed dramatic resolution of clot burden and nice penetration of contrast toward patent IVC (Figure 2).
case_images: Leakage out of caveofemoral junction extensively.
case_images: CRIVAM2017-3746815.003.jpg
case_images: PMC5603125_01_CRIVAM2017-3746815.003.jpg
case_images: fig3
case_images: During catheter passage and wire exchange, before deploying of stent, unfortunately we encountered leakage out of caveofemoral junction (the distal edge of IVC) extensively (Figure 3).
case_images: Unsuccessful result of balloon inflations forced us to decide to reverse anticoagulant condition of our patient (supine position).
case_images: CRIVAM2017-3746815.004.jpg
case_images: PMC5603125_01_CRIVAM2017-3746815.004.jpg
case_images: fig4
case_images: Unsuccessful result of balloon inflations which was showed in subsequent injections (Figure 4) forced us to decide to reverse anticoagulant condition of our patient (due to alteplase and heparin infusion).
case_images: Final result of procedure.
case_images: CRIVAM2017-3746815.005.jpg
case_images: PMC5603125_01_CRIVAM2017-3746815.005.jpg
case_images: fig5
case_images: Fortunately, this courageous strategy in spite of fear of stent thrombosis and even our patient primary pathology itself (acute thrombosis) causes leakage to diminish significantly and in following balloon inflations to stop completely (Figure 5).
case_images: Follow-up CT scan showed patent iliac vein stent.
case_images: CRIVAM2017-3746815.006.jpg
case_images: PMC5603125_01_CRIVAM2017-3746815.006.jpg
case_images: fig6
case_images: Although the next day pelvic and abdominal CT angiography showed the extent of patient bleeding and of course patent iliac vein stent (Figure 6), she passed an uneventful course in following days of admission.