Phlegmasia cerulea dolens is a potentially devastating complication of
extensive deep venous thrombosis for which there is currently no cons
ensus for treatment. Heparin anticoagulation, surgical thrombectomy, t
hrombolytic therapy, fasciotomy, and amputation have each been advocat
ed. We present two cases of phlegmasia cerulea dolens successfully tre
ated with catheter-directed venous thrombolytic therapy.