A 50-year-old female presents with right leg swelling and heaviness for three days. She is currently being treated with chemotherapy for colorectal cancer with liver extension and has a family history of deep venous thrombosis in her mother, although no hypercoagulable state was identified. On exam, she has mild pitting edema of her right thigh and calf with no extension to the foot. She has no edema on the left side. Arterial pulses are palpable in all distributions on both sides. A venous duplex exam is performed and shows that the left deep venous system is normal. The right deep venous system shows patency and compressibility of the right common femoral vein. The femoral vein and popliteal vein also shows compressibility and normal response to augmentation, and the peroneal and posterior tibial veins are patent with forward flow. Spectral Doppler analysis of the right common femoral vein waveform is demonstrated below.
Figure 1. Duplex Doppler of the right common femoral vein. Click for larger image
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