# Clinical Challenges in Vascular Surgery: Phlegmasia in Pregnancy

Page: https://stenobird.com/podcast/behind-the-knife-the-surgery-podcast-321171/clinical-challenges-in-vascular-surgery-phlegmasia-in-pregnancy
Text version: https://stenobird.com/podcast/behind-the-knife-the-surgery-podcast-321171/clinical-challenges-in-vascular-surgery-phlegmasia-in-pregnancy.md
Podcast: [Behind The Knife: The Surgery Podcast](https://stenobird.com/podcast/behind-the-knife-the-surgery-podcast-321171)
Published: 2026-06-08T07:00:00+00:00
Episode link: https://audioboom.com/posts/8911385
Audio file: https://pdst.fm/e/arttrk.com/p/ABMA5/pscrb.fm/rss/p/dts.podtrac.com/redirect.mp3/audioboom.com/posts/8911385.mp3?modified=1780497967&sid=5046960&source=rss
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JSON: https://stenobird.com/v1/public/podcasts/behind-the-knife-the-surgery-podcast-321171/episodes/clinical-challenges-in-vascular-surgery-phlegmasia-in-pregnancy
Duration seconds: 2305

## Resource

A 25-year-old pregnant woman presents with a 1-day history of progressive pain and swelling. The foot is cold, pulseless and neurologic function is deteriorating by the hour. Imaging shows a massive iliofemoral DVT. Now both the limb and the pregnancy are threatened. Do you anticoagulate, thrombolyse or operate? Join us as we break down the management and decision making behind this rare but devastating case. Hosts: · Christian Hadeed -PGY 4 General Surgery, Brookdale Hospital Medical Center · Paul Haser -Division Chief, Vascular Surgery, Brookdale Hospital Medical Center · Andrew Harrington, Vascular surgery, Brookdale Hospital Medical Center · Lucio Flores, Vascular surgery, Brookdale Hospital Medical Center Learning objectives: - Recognize the clinical presentation and pathophysiology of phlegmasia cerulea dolens - Describe how pregnancy affects decision making in patients with phlegmasia and venous thromboembolic disease - Discuss the goals of treatment for patients with DVT’s and identify when operative intervention is indicated - Describe the sequelae of DVT’s and how this relates to post thrombotic syndrome - Review the indications, risks, and limitations of anticoagulation, catheter-directed thrombolysis, thrombectomy, and fasciotomy in the management of DVT and phlegmasia. - Explain the role of IVUS in managing venous thromboembolic disease and May Thurner syndrome References: - Vedantham, S., Goldhaber, S. Z., Julian, J. A., Kahn, S. R., Jaff, M. R., Cohen, D. J., Magnuson, E., Razavi, M. K., Comerota, A. J., Gornik, H. L., Murphy, T. P., Lewis, L., Duncan, J. R., Nieters, P., Derfler, M. C., Filion, M., Gu, C.-S., Kee, S., Schneider, J., … Kearon, C. (2017). Pharmacomechanical catheter-directed thrombolysis for deep-vein thrombosis . New England Journal of M…

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