# Phlegmasia cerulea dolens after endovenous cyanoacrylate closure of incompetent small saphenous vein

## TL;DR

A woman developed severe leg vein clotting after a procedure to treat a faulty vein, but her symptoms improved with treatment.

## Contribution

This case highlights a rare complication of cyanoacrylate closure and its successful management.

## Key findings

- Grade 2 thrombosis occurred six days after cyanoacrylate closure of the small saphenous vein.
- Phlegmasia cerulea dolens developed, but symptoms resolved after anticoagulant treatment.
- Superficial vein thrombi resolved, though a deep venous thrombus remained.

## Abstract

A previously healthy 70-year-old woman underwent cyanoacrylate closure of an incompetent left small saphenous vein. Six days later, grade 2 treatment-induced thrombosis occurred at the sapheno-popliteal junction. Three days later, the patient presented with pale, cold pain in the left lower extremity. Diffuse thrombosis of the left lower extremity involved the small and great saphenous and deep veins. The patient was admitted and immediately administered heparin with anticoagulant factors, with symptoms began resolving 1 d later. The superficial vein thrombi were resolved. Although a deep venous thrombus remained, symptoms disappeared, and the patient was discharged.