Figure 9:

A 63-year-old female with metastatic breast carcinoma and a history of May Thurner syndrome status post left common iliac stent placement presents with worsening left lower extremity swelling. (a) CT (not shown) demonstrates thrombus extending from the left common iliac to the superficial and profunda femoral veins, which was confirmed on venography with pelvic collaterals visualized (arrows). (b) The patient underwent AngioJet pharmacomechanical thrombectomy (arrow) of the left lower extremity and subsequent 16 mm balloon angioplasty of the stent with proximal extension into the IVC using a 16 mm × 60 mm Wallstent. (c) This shows significantly improved outflow through the stent and decreased pelvic collateralization.