Subacute DAY-13 femoro-popliteal deep vein thrombosis in an older adult: Rapid venous reperfusion to prevent post-thrombotic syndrome – a case report

Abstract Background Femoro-popliteal deep vein thrombosis (DVT) is a medical condition characterized by the formation of a thrombus within the deep venous system and carries the risk of serious complications for pulmonary embolism and Post Thrombotic Syndrome (PTS). Early reperfusion therapy in selected subacute cases may reduce the risk of long-term complications. Case Illustration A 68-year-old obese woman with a sedentary lifestyle and history of prolonged sitting during long distance travel presented with a 13 day history of progressive swelling, pain, and erythema of the left leg. Laboratory findings showed elevated D-dimer and prolonged activated partial thromboplastin time (APTT), with otherwise normal renal and hepatic function. Doppler ultrasonography revealed occlusive thrombus in the left femoral vein (mid- to distal-third, ∼14 cm) and the left popliteal vein (∼6.2 cm). Considering the subacute phase and high risk for Post Thrombotic Syndrome she underwent rheolytic thrombectomy, achieving near complete venous reperfusion. Outcome: At one year follow up, there was marked reduction of leg swelling without recurrence of thrombosis or clinical signs of Post Thrombotic Syndrome Conclusion This case highlights that even in subacute femoro-popliteal Deep Vein Thrombosis, early mechanical thrombectomy can restore venous patency and prevent Post Thrombotic Syndrome in carefully selected older adults.