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case_images: Contrast-enhanced computed tomography. (A, B) Multiple thrombi in both pulmonary arteries (arrow). (C, D) No compression of the left common iliac vein was observed. The right external iliac vein ran between the right internal iliac artery and external iliac artery but could not be adequately evaluated. CIA, common iliac artery; CIV, common iliac vein; EIV, external iliac vein; IIA, internal iliac artery; EIA, external iliac artery.
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case_images: Subsequently, contrast-enhanced computed tomography (CT) was performed, revealing multiple thrombi in both pulmonary arteries (Figure 1A and B). No compression of the left common iliac vein was observed (Figure 1C). The right external iliac vein (EIV) ran between the right internal iliac artery (IIA) and external iliac artery (EIA), but its evaluation was insufficient (Figure 1D).
case_images: Venous phase of contrast-enhanced computed tomography. Thrombus was observed from the distal side of the right femoral vein to the deep leg vein (Red arrows).
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case_images: Imaging obtained during the venous phase revealed a thrombus from the distal side of the right femoral vein to the deep leg vein (Figure 2).
case_images: Lower extremity MRA. The right external iliac vein was compressed by the right internal iliac artery and external iliac artery. Quantitative evaluation showed that the distal external iliac vein maximum minor diameter was 13.3 mm (E) and that the maximum compression diameter was 2.1 mm (B), indicating severe stenosis (84%). %stenosis = (maximum minor diameter - maximum compression diameter)/maximum minor diameter). EIV, external iliac vein; IIA, internal iliac artery; EIA, external iliac artery.
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case_images: This revealed compression of the right EIV by the right IIA and EIA (Figure 3).
case_images: Lower extremity ultrasonography 6 months after discharge. Residual thrombus was observed (arrow).
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case_images: Nonetheless, despite the absence of dyspnoea or lower limb oedema, lower extremity ultrasonography performed 6 months later revealed residual thrombus (Figure 4).