Presenter: Marco Pontt

Hospital: Asklepios Klinik St. Georg, Hamburg, Germany

Summary

A 23-year-old female with chronic exertional exhaustion presented with bilateral leg swelling and pulmonary embolism. Imaging revealed fibrotic inferior vena cava (IVC) stenosis. Mechanical thrombectomy and stenting restored venous flow, resolving symptoms. Retrospective analysis linked exhaustion to chronic venous obstruction.

Introduction

Chronic IVC obstruction may mimic functional disorders, leading to delayed diagnosis. Early intervention with thrombectomy and stenting can reverse hemodynamic compromise.

Case analysis

Clinical Profile: 10-year exertional fatigue, acute leg swelling, PE.

Imaging: Fibrotic IVC stenosis with thrombus extension.

Procedure: Bilateral popliteal access thrombectomy + stenting.

Outcome: Symptoms resolved; exhaustion attributed to chronic venous hypertension.

Conclusion

Chronic venous obstruction is an underrecognized cause of exertional exhaustion. Endovascular therapy restores flow and enhances functional capacity.