[Endovascular treatment of chronic iliac vein obstruction in patients with venous claudication].
BACKGROUND
Proximal deep venous thrombosis (DVT) often leads to venous outflow obstruction in chronic venous insufficiency (CVI). This paper presents our clinical experience with iliac vein stent placement.


METHODS
Between January 2001 and November 2004 balloon dilation and stent placement for the relief of iliac vein obstruction was intended in ten patients suffering from venous claudication. Median age was 35 years (range 21-42). Eight patients had earlier been treated for proximal DVT on the left side and two patients had May-Thurner syndrome. Ultrasound scanning was performed on all patients for the detection of iliac vein obstruction. It was a requirement that all patients had an open deep venous system without reflux distally to the occlusion. The procedure was carried out under local anaesthesia and all patients were anticoagulated postoperatively.


RESULTS
There was one technical failure and nine patients were treated successfully. In one of these patients the stent rethrombosed after two days but the thrombus was lysed and the patient was restented more distally. All patients were discharged with an open venous system. At follow-up, eight of the nine stents were patent. Five patients had normal walking distance and three had improved. The median follow-up time was 32.5 months (range 6-53 months).


CONCLUSIONS
The correction of iliac vein obstruction with the placement of stents in patients with venous claudication seems to be an effective, safe method which is minimally invasive. Short term patency is satisfactory but the long term results of stents in the venous system are not known and longer follow-up is required.
Broholm
Rikke
R
Gentofte Hospital, Karkirurgisk Afdeling B, Hellerup. rbroholm@dadlnet.dk
Baekgaard
Niels
N
Just
Sven R Lundgren
SR
Jørgensen
Maja
M
D000328:Adult; D002404:Catheterization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D007383:Intermittent Claudication / Q000628:therapy*; D008297:Male; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000628:therapy*