Female initially presenting with pelvic venous congestion secondary to Nutcracker Phenomena. After treatment of the PVC, the patients pelvic complaints improved but they developed worsening symptoms of Nutcracker Syndrome. The NCS was treated with renal vein stenting and the symptoms improved. However, the patient had new right sided pain with deep breathing. The renal vein stent was impinging on the lateral wall of the IVC. The stent was partially extracted with improvement of pain.
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.
22 year old with severe post thrombotic syndrome 6 months after left leg deep venous thrombosis (DVT).
94 year old female, worsening right toe and foot pain. Seen by primary care and diagnosed as having gout.