Radiation-associated venous stenosis: endovascular treatment options.
We report a case of radiation-induced venous stenosis after pelvic irradiation to treat Paget's disease of the scrotum. During therapeutic anticoagulation, significant left lower extremity swelling developed due to an iliofemoral deep venous thrombosis (DVT). After percutaneous thrombectomy and thrombolysis, a high-grade stenosis was uncovered in the left external iliac vein, which was treated with an endoluminal stent. However, ipsilateral DVT recurred 2 months later despite continued anticoagulation therapy. Repeat treatment was successful. Pelvic radiation is a potential cause of iliac vein stenosis. Pharmacomechanical thrombectomy may have a useful role in management of complex iliofemoral DVT.
Zhou
Wei
W
Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, The Methodist Hospital, Houston, TX 77030, USA.
Bush
Ruth L
RL
Lin
Peter H
PH
Lumsden
Alan B
AB
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D010145:Paget Disease, Extramammary / Q000532:radiotherapy; D019919:Prosthesis Implantation / Q000379:methods*; D011832:Radiation Injuries / Q000150:complications*; D012008:Recurrence; D015607:Stents; D017131:Thrombectomy / Q000379:methods; D014652:Vascular Diseases / Q000209:etiology / Q000628:therapy*; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy
D000925:Anticoagulants