Occupational suspension and extensive iliocaval thrombosis in a young man with multiple thrombotic risk factors: a case report

Extensive deep vein thrombosis in a young patient warrants thorough investigation of potential predisposing factors, including genetic, anatomical, and acquired conditions. Occupational history should also be considered, as prolonged suspension work using ropes may contribute to venous thrombosis. We report the case of a 30-year-old man with extensive deep vein thrombosis. His history revealed active smoking, heterozygosity for Factor V Leiden and the MTHFR variant, and prolonged occupational suspension. CT imaging showed venous wall abnormalities and collateral circulation, suggesting a possible underlying chronic venous disorder. Given the extent and persistence of thrombosis despite anticoagulant therapy, catheter-directed thrombus aspiration and venous angioplasty were performed, resulting in progressive clinical improvement. This case highlights prolonged occupational suspension as a possible contributing factor to thrombosis and suggests that the interaction between genetic predisposition, underlying venous abnormalities, and mechanical factors may contribute to severe and unusual thrombotic events in young individuals requiring careful diagnostic evaluation.