Simultaneous arterial and venous ultrasound-assisted thrombolysis for phlegmasia cerulea dolens.

Phlegmasia cerulea dolens is a rare condition in which an extensive deep venous thrombus can partially or completely occlude venous outflow from the affected extremity. Clinical presentation is typically characterized by extremity edema, cyanosis, and pain. This condition is associated with a high rate of extremity amputation and mortality. Although numerous therapies have been described, there is no generalized treatment consensus and less invasive forms of therapy continue to evolve. We report a case of phlegmasia cerulea dolens in a patient who presented with concomitant arterial and venous thrombosis of the affected extremity. The patient's condition was successfully treated using combined ultrasound-assisted intra-arterial and intravenous catheter-directed thrombolysis.