| Diagnosis and endovascular treatment of iliocaval compression syndrome. | |
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MedLine Citation:
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PMID: 11436082 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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D R Hurst; A R Forauer; J R Bloom; L J Greenfield; T W Wakefield; D M Williams |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of vascular surgery Volume: 34 ISSN: 0741-5214 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2001 Jul |
Date Detail:
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Created Date: 2001-07-03 Completed Date: 2001-08-09 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 106-13 Citation Subset: IM |
Affiliation:
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Department of Radiology, Division of Vascular and Interventional Radiology, the University of Michigan Medical Center, Ann Arbor 48109-0326, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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