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Case Reports: Reminder of important clinical lesson
Deep venous thrombosis post mechanical thrombectomy in acute ischaemic stroke
  1. Branimir Nevajda1,2,
  2. Jigisha Amin1,2,
  3. Ali Zaman1,3 and
  4. Paul Bhogal4
  1. 1Basildon & Thurrock University Hospital, Mid and South Essex NHS Foundation Trust, Basildon, UK
  2. 2Department of Stroke Medicine, Mid and South Essex NHS Foundation Trust, Basildon, UK
  3. 3Department of Radiology, Mid and South Essex NHS Foundation Trust, Basildon, UK
  4. 4Department of Interventional Neuroradiology, The Royal London Hospital, London, UK
  1. Correspondence to Dr Jigisha Amin; jigisha.amin{at}nhs.net

Abstract

A woman in her 20s presented with neck pain, slurred speech and left-sided weakness. She successfully underwent mechanical thrombectomy (MT) for total occlusion of the basilar artery and made full neurological recovery. Initial ultrasound Doppler of legs (USDL) did not show any deep vein thrombosis (DVT). However, 2 days later, a repeat USDL revealed an extensive proximal DVT in the right common femoral vein. CT scan confirmed a haematoma arising from the femoral access site causing compression of the adjacent common femoral vein. This may have initiated DVT formation or exacerbated extension of a previously undetected DVT. Echocardiogram revealed a patent foramen ovale. As the patient was asymptomatic, delayed or missed diagnosis of DVT would have put her at risk of life-threatening pulmonary embolism or further strokes. Clinicians should maintain a high index of suspicion of DVT as a direct procedural complication from MT so treatment can be initiated promptly.

  • Stroke
  • Interventional radiology
  • Venous thromboembolism

https://doi.org/10.1136/bcr-2023-255391

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: BN, JA, AZ and PB. The following authors gave final approval of the manuscript: BN, JA, AZ and PB.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.