Young patients with iliofemoral deep venous thrombosis should receive thrombolytic therapy.

Abstract

A 20-year-old otherwise healthy woman on oral contraceptive pills presents with sudden-onset left leg swelling and pain extending from her calf to her groin. Pulmonary embolism symptoms are lacking. Venous duplex ultrasound reveals acute deep venous thrombosis (DVT) involving the distal external iliac, common femoral, superficial femoral, and popliteal veins. Her leg is markedly swollen, slightly cool to the touch, but has preserved pedal pulses. She is unable to ambulate secondary to pain. Thrombolytic therapy to eliminate the DVT is recommended.