35-Year-Old Female Patient Presents with Purple Stain to Right Lateral Thigh

• 35yo F presents to CHCO VAC 11/2018
• Purple stain to right lateral thigh, RLE overgrowth, blebbing to foot, right buttock, groin
• Evaluated at multiple facilities throughout lifetime and received multiple diagnoses
• Has undergone several surgical excisions of bothersome “hemangiomas”
• DVT at R knee @ 18yo. Coumadin since that time
• Main complaints:
  • Syncopal unless wearing compression
  • Painful blebbing in groin
• Diagnosis of Klippel-Trenaunay Syndrome

Treatment Options

• Patient progressed to syncopal episodes while wearing compression, likely due to large size of marginal vein
• Concern regarding presence of deep venous system
• Would marginal vein ablation lead to venous congestion?
• Referral to Vascular Surgery, considered:
  • Resection of vein
  • Surgical ligation
  • Radio-frequency ablation

Outcomes

• Patient received venogram and ascending phlebograpy 12/2019, which demonstrated presence of deep venous system
• Radio-frequency ablation to RLE marginal vein at the knee
• Patient has demonstrated a drastic improvement in orthostasis
• No syncopal episodes while wearing compression
• Able to walk short distances without a compression garment