Document Detail


Diagnosis and endovascular treatment of iliocaval compression syndrome.
MedLine Citation:
PMID:  11436082     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 > or = 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.
Authors:
D R Hurst; A R Forauer; J R Bloom; L J Greenfield; T W Wakefield; D M Williams
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  34     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-03     Completed Date:  2001-08-09     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  106-13     Citation Subset:  IM    
Affiliation:
Department of Radiology, Division of Vascular and Interventional Radiology, the University of Michigan Medical Center, Ann Arbor 48109-0326, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Balloon Dilation*
Constriction, Pathologic
Female
Humans
Iliac Vein* / pathology,  ultrasonography
Male
Peripheral Vascular Diseases / diagnosis*,  therapy*,  ultrasonography
Retrospective Studies
Sensitivity and Specificity
Stents*
Syndrome
Ultrasonography, Interventional
Vascular Patency
Venous Thrombosis / diagnosis,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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