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Angiology
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Phlegmasia Cerulea Dolens and Its Association with Hypercoagulable States: Case Reports

David J. Cohen

From the Cardiothoracic Surgery Service, Brooke Army Medical Center, Ft. Sam Houston, Texas, From the Division of Cardiothoracic Surgery and Vascular Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin, Division of Cardiothoracic Surgery, University of Texas Health Science Center, San Antonio, Texas

Richard Briggs

From the Cardiothoracic Surgery Service, Brooke Army Medical Center, Ft. Sam Houston, Texas

Harold D. Head

From the Cardiothoracic Surgery Service, Brooke Army Medical Center, Ft. Sam Houston, Texas

Charles W. Acher

From the Division of Cardiothoracic Surgery and Vascular Surgery, University of Wisconsin School of Medicine, Madison, Wisconsin

Six patients who developed phlegmasia cerulea dolens are described. All pa tients had associated hypercoagulable states: heparin-induced thrombocytope nia (2 patients), congenital deficiency of protein C (1 patient), and antithrombin III deficiency (3 patients). Their clinical course and management are discussed. Previous reports have failed to show a definite correlation between phlegmasia cerulea dolens and hypercoagulable states because of an unavailability of appro priate diagnostic techniques. Phlegmasia cerulea dolens is a life- and limb- threatening complication. An appreciation of underlying hypercoagulable states is essential to proper management, prophylaxis, and treatment of this disorder.

Angiology, Vol. 40, No. 5, 498-508 (1989)
DOI: 10.1177/000331978904000513
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