What are the risk factors for phlegmasia alba dolens (PAD) and phlegmasia cerulea dolens (PCD)?

Updated: Jul 27, 2020
  • Author: Cassius Iyad Ochoa Chaar, MD, MS, FACS; Chief Editor: Vincent Lopez Rowe, MD  more...
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Malignancy is the most common triggering factor and is present in approximately 20-40% of patients with PCD. [10] The presence of malignancy is also associated with higher mortality. Other associated risk factors include the following:

  • Hypercoagulable syndrome
  • Surgery
  • Inferior vena cava filter insertion
  • May-Thurner syndrome (compression of the left iliac vein by the right iliac artery)

Pregnancy has often been associated with PAD, especially during the third trimester, when the uterus is large enough to compress the left common iliac vein against the pelvic rim (ie, milk leg syndrome). Finally, 10% of patients with phlegmasia have no apparent risk factors.

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