38 year old female with deep venous thrombosis 14 years ago while on birth control pills. Second DVT shortly after discontinuing anti-coagulation. Hematologic work up showed the patient to have Protein S deficiency. Patient suffered with severe post thrombotic syndrome eventually resulting in venous ulceration 8 years ago. Patient suffered with a chronic ulcer that was eventually healed after venoplasty of the femoral and popliteal veins.
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.
101 year old female, admitted to the hospital with foot and toe pain. Patient had a cool pulseless foot.
65 year old cyclist with extensive superficial and deep venous incompetence and venous ulceration