Extensive Collateral Venous Circulation and Anatomic Remodeling in Chronic Deep Vein Thrombosis

Chronic deep venous thrombosis (DVT) can result in a significant venous outflow obstruction, often prompting the development of extensive compensatory mechanisms to maintain adequate circulation. We report a case of recurrent DVT, presenting with left lower extremity pain and edema. Venography revealed complete occlusion of the left common femoral vein with extensive collateral venous circulation. Given the presence of well-formed collaterals and clinical stability, the patient was treated conservatively with continued anticoagulation without additional invasive intervention. This case highlights the physiologic adaptation of collateral formation that can allow for conservative management in chronic DVT and contributes to a better understanding of management strategies for high-risk patients with recurrent thrombotic events.