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Diagnosis and endovascular treatment of iliocaval compression syndrome

Journal of vascular surgery, 2001-07, Vol.34 (1), p.106-113 [Peer Reviewed Journal]

2001 Society for Vascular Surgery and The American Association for Vascular Surgery ;2002 INIST-CNRS ;ISSN: 0741-5214 ;EISSN: 1097-6809 ;DOI: 10.1067/mva.2001.114213 ;PMID: 11436082 ;CODEN: JVSUES

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Title:
Diagnosis and endovascular treatment of iliocaval compression syndrome
Author: Hurst, Darren R. ; Forauer, Andrew R. ; Bloom, Jess R. ; Greenfield, Lazar J. ; Wakefield, Thomas W. ; Williams, David M.
Subjects: Adult ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Catheterization ; Constriction, Pathologic ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Female ; Humans ; Iliac Vein - diagnostic imaging ; Iliac Vein - pathology ; Male ; Medical sciences ; Peripheral Vascular Diseases - diagnosis ; Peripheral Vascular Diseases - diagnostic imaging ; Peripheral Vascular Diseases - therapy ; Retrospective Studies ; Sensitivity and Specificity ; Stents ; Syndrome ; Ultrasonography, Interventional ; Vascular Patency ; Venous Thrombosis - diagnosis ; Venous Thrombosis - therapy
Is Part Of: Journal of vascular surgery, 2001-07, Vol.34 (1), p.106-113
Description: Purpose: The purpose of this study was to evaluate the clinical presentation, diagnosis, and endovascular treatment of iliocaval compression syndrome (ICS). Patients and Methods: During a 3-year period, 18 patients (17 women, 1 man; mean age, 42 years) presented with clinical and imaging findings consistent with ICS. All patients were evaluated with venography and Doppler ultrasound (DUS), 13 of 18 with intravascular pressure measurements, 12 of 18 with intravascular ultrasound, 9 of 18 with air plethysmography (APG), and 4 of 18 with magnetic resonance venography. Seventeen patients were treated with endovascular stenting, one was treated with angioplasty alone, and six received adjunct thrombolysis. Results: Despite the presence of stenosis or occlusion in all cases, APG indicated no iliac vein obstruction (outflow fraction ≥ 40%) in nine patients. DUS revealed acute (6) or chronic (7) unilateral iliofemoral deep venous thrombosis in 13 of 18 patients, whereas the results of five of 18 DUS studies were normal. Recanalization and stent placement (n = 17) or angioplasty (n = 1) was achieved in all patients. The average pressure gradient was 5.6 mm Hg preprocedure and 0.6 mm Hg postprocedure. The primary patency rate demonstrated with DUS (n = 17) and venography (n = 7) at 6 months was 89%. The primary patency rate at 12 months was 79%. Conclusions: ICS often presents as sudden unilateral left lower extremity pain and swelling in young to middle-aged female patients after pregnancy, surgery, or a period of inactivity. Venography, intravascular ultrasound, and magnetic resonance venography demonstrate high sensitivity, whereas APG–outflow fraction demonstrates low sensitivity in the diagnosis of ICS. Endovascular stenting and angioplasty provide safe and effective early and intermediate-term treatment of symptomatic ICS. (J Vasc Surg 2001;34:106-13.)
Publisher: New York, NY: Elsevier Inc
Language: English
Identifier: ISSN: 0741-5214
EISSN: 1097-6809
DOI: 10.1067/mva.2001.114213
PMID: 11436082
CODEN: JVSUES
Source: MEDLINE
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Diagnosis and endovascular treatment of iliocaval compression syndrome

2001 Society for Vascular Surgery and The American Association for Vascular Surgery ;2002 INIST-CNRS ;ISSN: 0741-5214 ;EISSN: 1097-6809 ;DOI: 10.1067/mva.2001.114213 ;PMID: 11436082 ;CODEN: JVSUES

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