Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with unilateral left lower extremity edema, heaviness, and discomfort. Symptoms are chronic/progressive, exacerbated by prolonged standing. No history of recent trauma or immobilization. Denies chest pain or dyspnea. History significant for [Insert Risk Factors]. Clinical suspicion for iliac vein compression syndrome (May-Thurner).
Clinical Examination Findings
Left lower extremity: Significant pitting edema (1+ to 4+), venous distension, and hyperpigmentation noted. Tenderness along the femoral vein. Pulses are 2+ and symmetric. No signs of acute DVT (Homanโs sign negative). Skin integrity intact; no ulcerations. Abdominal exam: Non-tender, no pulsatile masses.
Treatment Protocol
Plan: 1. Venous duplex ultrasound and/or MRV/CTV to confirm iliac vein compression. 2. Anticoagulation therapy as indicated. 3. Referral to Interventional Radiology for catheter-directed thrombolysis (if acute) or angioplasty/stenting of the left common iliac vein. 4. Compression therapy (Class II stockings). 5. Follow-up in [Insert Timeframe].