A Blue Leg: An Interventional Approach to a Limb-Threatening Deep Vein Thrombosis
Bibliographic record
Abstract
Phlegmasia cerulea dolens (PCD) is a rare complication of acute deep vein thrombosis (DVT) characterized by fulminant venous thrombosis that compromises arterial blood flow, resulting in tissue ischemia, venous gangrene, and possible loss of limb. A high rate of morbidity and mortality associated with PCD requires prompt recognition and treatment. An accepted therapeutic algorithm for the management of PCD does not currently exist. Acute reduction in clot burden can be achieved through catheter-directed thrombolysis (CDT) with lower rates of post-thrombotic symptoms, and there has been a recent trend toward use of CDT. We report the case of a 26-year-old female who presented with PCD of her left leg and underwent successful CDT, highlighting the benefits of rapid recognition of a rare complication of acute DVT, and the role for a multidisciplinary endovascular approach to managing fulminant limb-threatening venous thrombosis. La phlegmatia caerulea dolens (PCD) est une complication rare de la thrombose veineuse profonde (TVP) aiguë caractérisée par une thrombose veineuse foudroyante qui compromet le débit sanguin et résulte en une ischémie tissulaire, une évolution vers la gangrène et le risque de perte de membre. La PCD est associée à un taux élevé de morbidité et de mortalité et requiert une reconnaissance et un traitement rapides. Il n’existe actuellement pas de modèle défini d’intervention pour la prise en charge de la PCD. Une réduction rapide du caillot peut être obtenue par thrombolyse guidée par cathéter (TGC), intervention associée à un taux plus faible de symptômes post-thrombotiques. Le recours à la TGC est d’ailleurs plus fréquent depuis peu. Nous décrivons ici le cas d’une patiente âgée de 26 ans qui présentait une PCD à la jambe gauche et qui a été traitée avec succès par TGC. Ce cas fait ressortir l’importance de savoir reconnaître rapidement une complication rare de la TVP aiguë, ainsi que d’appliquer une approche endovasculaire multidisciplinaire dans la prise en charge d’une thrombose veineuse fulminante susceptible de causer la perte d’un membre.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".