JACC Case Rep. 2026 Jul 1:108911. doi: 10.1016/j.jaccas.2026.108911. Online ahead of print.
ABSTRACT
BACKGROUND: Post-thrombotic syndrome (PTS) is a debilitating complication of deep vein thrombosis, characterized by venous obstructions that impede cephalad flow, elevated venous pressure, and risk of venous ulceration.
CASE SUMMARY: A 73-year-old woman with severe PTS presented with multilevel venous occlusions involving the popliteal vein, femoral vein, and common femoral vein, and a thrombosed right external iliac-common femoral vein stent. Given the complex presentation, an endovascular intervention was performed to restore venous patency. The procedure successfully cleared the occlusions and in-stent thrombosis in a single session. The patient's symptoms, including swelling, pain, erythema, and open wound, improved, with patency sustained through 2-year follow-up.
DISCUSSION: This case highlights the challenges of managing advanced PTS with multilevel venous obstruction and in-stent thrombosis, conditions associated with significant morbidity.
TAKE-HOME MESSAGES: Comprehensive endovascular management can restore venous outflow in complex PTS. Durable outcomes require ongoing surveillance and optimized medical therapy.
PMID:42383950 | DOI:10.1016/j.jaccas.2026.108911