Free-floating femoral vein thrombus in a patient with aspergillosis

The management of a free-floating thrombus in the femoropopliteal or ilioca val veins is controversial. Such patients may have an increased risk of pul monary embolism. The differential diagnosis of intraluminal venous malignan cy or septic thrombosis must also be considered, especially in immunocompro mised patients. This report reviews the management of a 56-year-old woman w ith bronchopulmonary aspergillosis who was found to have a free-floating th rombus in the femoral vein. Appropriate preoperative evaluation, emphasizin g non-invasive studies and duplex exam, are discussed. In addition, the dif ferential diagnosis, surgical options and perioperative care are considered . This patients represents a complex case of venous thrombosis in an immuno compromised patient and, therefore, the optimal care to minimize complicati ons, such as pulmonary embolism, and prevent recurrence or post-thrombotic changes, is necessary.