Tuesday, April 4, 2023

Subacute thrombosis of the femoral and popliteal veins

This adult patient had pain and mild edema of the right foot. 
Color Doppler ultrasound was performed and revealed these ultrasound images:

Femoral vein,  large thrombus 

Near total occlusion of femoral vein:
Long section of femoral vein 👆
Full length of thrombus in femoral vein 👆👇
On valsalva maneuver the femoral vein is fully distended and shows the thrombus partially floating in the lumen 👇
On color Doppler ultrasound flow seen around the side of thrombus. 👇
Popliteal vein also shows near total thrombosis 👇👇
Popliteal V diameter is almost double the size of Popliteal artery due to thrombosis. 👇

Color Doppler of Popliteal vein shows absent flow 👇
Popliteal vein spectral Doppler: no flow 👇

Final diagnosis: subacute thrombosis of right femoral and popliteal veins. 

More on this topic:
Subacute thrombosis refers to the formation of a blood clot in a vein that has been present for several days to a few weeks.
Ultrasound and color Doppler ultrasound imaging are non-invasive techniques that can be used to detect subacute thrombosis in the right femoral and popliteal veins.
The ultrasound imaging shows a hypoechoic or isoechoic thrombus within the lumen of the affected femoral and popliteal veins. 
The color Doppler ultrasound will demonstrate absent or reduced blood flow in the affected vein.
Symptoms:
Patients with subacute thrombosis may present with symptoms such as leg pain, swelling, and warmth.
Risk factors:
The risk of subacute thrombosis is higher in patients with underlying risk factors such as recent surgery, immobilization, pregnancy, cancer, and genetic predisposition.
Treatment:
Treatment of subacute thrombosis typically involves anticoagulation therapy to prevent the growth of the clot and reduce the risk of complications such as pulmonary embolism.
In some cases, additional interventions such as thrombolysis or surgical thrombectomy may be necessary to remove the clot.
Follow-up ultrasound imaging may be required to monitor the resolution of the clot and ensure that there are no recurrent thromboses. 

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