Iliac vein rupture is a rare cause of retroperitoneal hemorrhage. It is occasionally lethal, with no clear precipitating factors. We report a case of spontaneous left external iliac vein rupture in a 78-year-old woman with deep vein thrombosis (DVT) of the left iliac vein. Her lower extremity swelling for several days who subsequently developed hemorrhagic shock and had to be taken emergently to surgery. Rupture of the left external iliac veins was identified intraoperatively. We find a 2-cm longitudinal tear on the anterior surface of the vein which was repaired primarily. Anticoagulation therapy has done postoperatively for DVT.

A 78-year-old man visited our department with complaint of pain in the right lower limb that had developed after dinner, followed by cold sense on the next morning. CTA revealed complete occlusion of the proximal right superficial femoral artery. Because he exercised, senses in his right toe were not lost. We then decided to perform embolectomy. Because embolectomy using a Fogarty catheter was unsuccessful, we aspirated a direct thrombus using a 9-Fr OPTIMO occlusion catheter and achieved recanalization. Thus, we suggest that thrombus aspiration using the OPTIMO occlusion catheter for acute arterial occlusion of lower limbs is effective.