Case Report: Extensive deep vein thrombosis and venous pseudoaneurysm following percutaneous transcatheter tricuspid valve intervention

IntroductionTranscatheter tricuspid valve intervention (TTVI) has evolved as a less-invasive alternative to surgical treatment of severe tricuspid regurgitation. Although venously delivered valves have been introduced, the risk of venous access site complications is unknown. We present a patient who...

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Main Authors: Zaid Abood, M. Fuad Jan, Eric S. Weiss, Tanvir Bajwa, Suhail Q. Allaqaband, Mark W. Mewissen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1568102/full
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author Zaid Abood
M. Fuad Jan
M. Fuad Jan
Eric S. Weiss
Eric S. Weiss
Tanvir Bajwa
Tanvir Bajwa
Suhail Q. Allaqaband
Suhail Q. Allaqaband
Mark W. Mewissen
Mark W. Mewissen
author_facet Zaid Abood
M. Fuad Jan
M. Fuad Jan
Eric S. Weiss
Eric S. Weiss
Tanvir Bajwa
Tanvir Bajwa
Suhail Q. Allaqaband
Suhail Q. Allaqaband
Mark W. Mewissen
Mark W. Mewissen
author_sort Zaid Abood
collection DOAJ
description IntroductionTranscatheter tricuspid valve intervention (TTVI) has evolved as a less-invasive alternative to surgical treatment of severe tricuspid regurgitation. Although venously delivered valves have been introduced, the risk of venous access site complications is unknown. We present a patient who suffered phlegmasia cerulea dolens post-TTVI.Case summaryWe present an 88-year-old female patient who developed phlegmasia cerulea dolens of the right lower extremity shortly after successful TTVI delivered through the right common femoral vein via a 35F sheath. Ipsilateral transpopliteal venography demonstrated an occlusive thrombus in the right common femoral vein and the incidental finding of an external iliac vein pseudoaneurysm. Endovascular treatment consisting of mechanical thrombectomy followed by adjunctive placement of self-expanding metallic stents resulted in restoration of iliofemoral venous outflow and excellent recovery with resolution of the patient's symptoms.ConclusionsSurveillance, e.g., duplex ultrasonography, immediately post-TTVI is important to rule out acute thrombosis of the venous access site and other complications associated with a large sheath.
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spelling doaj-art-f0a1696cda4e4b37a535ee0d5bba8c3d2025-08-20T03:49:46ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-05-011210.3389/fcvm.2025.15681021568102Case Report: Extensive deep vein thrombosis and venous pseudoaneurysm following percutaneous transcatheter tricuspid valve interventionZaid Abood0M. Fuad Jan1M. Fuad Jan2Eric S. Weiss3Eric S. Weiss4Tanvir Bajwa5Tanvir Bajwa6Suhail Q. Allaqaband7Suhail Q. Allaqaband8Mark W. Mewissen9Mark W. Mewissen10Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Aurora Health Care, Milwaukee, WI, United StatesAurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Aurora Health Care, Milwaukee, WI, United StatesDivision of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Milwaukee Clinical Campus, Milwaukee, WI, United StatesAurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Aurora Health Care, Milwaukee, WI, United StatesDivision of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Milwaukee Clinical Campus, Milwaukee, WI, United StatesAurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Aurora Health Care, Milwaukee, WI, United StatesDivision of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Milwaukee Clinical Campus, Milwaukee, WI, United StatesAurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Aurora Health Care, Milwaukee, WI, United StatesDivision of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Milwaukee Clinical Campus, Milwaukee, WI, United StatesAurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Aurora Health Care, Milwaukee, WI, United StatesDivision of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Milwaukee Clinical Campus, Milwaukee, WI, United StatesIntroductionTranscatheter tricuspid valve intervention (TTVI) has evolved as a less-invasive alternative to surgical treatment of severe tricuspid regurgitation. Although venously delivered valves have been introduced, the risk of venous access site complications is unknown. We present a patient who suffered phlegmasia cerulea dolens post-TTVI.Case summaryWe present an 88-year-old female patient who developed phlegmasia cerulea dolens of the right lower extremity shortly after successful TTVI delivered through the right common femoral vein via a 35F sheath. Ipsilateral transpopliteal venography demonstrated an occlusive thrombus in the right common femoral vein and the incidental finding of an external iliac vein pseudoaneurysm. Endovascular treatment consisting of mechanical thrombectomy followed by adjunctive placement of self-expanding metallic stents resulted in restoration of iliofemoral venous outflow and excellent recovery with resolution of the patient's symptoms.ConclusionsSurveillance, e.g., duplex ultrasonography, immediately post-TTVI is important to rule out acute thrombosis of the venous access site and other complications associated with a large sheath.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1568102/fullaccess site complicationcase reportdeep vein thrombosisphlegmasia cerulea dolenstranscatheter tricuspid valve replacementvenous pseudoaneurysm
spellingShingle Zaid Abood
M. Fuad Jan
M. Fuad Jan
Eric S. Weiss
Eric S. Weiss
Tanvir Bajwa
Tanvir Bajwa
Suhail Q. Allaqaband
Suhail Q. Allaqaband
Mark W. Mewissen
Mark W. Mewissen
Case Report: Extensive deep vein thrombosis and venous pseudoaneurysm following percutaneous transcatheter tricuspid valve intervention
Frontiers in Cardiovascular Medicine
access site complication
case report
deep vein thrombosis
phlegmasia cerulea dolens
transcatheter tricuspid valve replacement
venous pseudoaneurysm
title Case Report: Extensive deep vein thrombosis and venous pseudoaneurysm following percutaneous transcatheter tricuspid valve intervention
title_full Case Report: Extensive deep vein thrombosis and venous pseudoaneurysm following percutaneous transcatheter tricuspid valve intervention
title_fullStr Case Report: Extensive deep vein thrombosis and venous pseudoaneurysm following percutaneous transcatheter tricuspid valve intervention
title_full_unstemmed Case Report: Extensive deep vein thrombosis and venous pseudoaneurysm following percutaneous transcatheter tricuspid valve intervention
title_short Case Report: Extensive deep vein thrombosis and venous pseudoaneurysm following percutaneous transcatheter tricuspid valve intervention
title_sort case report extensive deep vein thrombosis and venous pseudoaneurysm following percutaneous transcatheter tricuspid valve intervention
topic access site complication
case report
deep vein thrombosis
phlegmasia cerulea dolens
transcatheter tricuspid valve replacement
venous pseudoaneurysm
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1568102/full
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