Endovascular treatment for iliac vein compression syndrome: a comparison between the presence and absence of secondary thrombosis.
OBJECTIVE
To evaluate the value of early identification and endovascular treatment of iliac vein compression syndrome (IVCS), with or without deep vein thrombosis (DVT).


METHODS
Three groups of patients, IVCS without DVT (group 1, n = 39), IVCS with fresh thrombosis (group 2, n = 52) and IVCS with non-fresh thrombosis (group 3, n = 34) were detected by Doppler ultrasonography, magnetic resonance venography, computed tomography or venography. The fresh venous thrombosis were treated by aspiration and thrombectomy, whereas the iliac vein compression per se were treated with a self-expandable stent. In cases with fresh thrombus, the inferior vena cava filter was inserted before the thrombosis suction, mechanical thrombus ablation, percutaneous transluminal angioplasty, stenting or transcatheter thrombolysis.


RESULTS
Stenting was performed in 111 patients (38 of 39 group 1 patients and 73 of 86 group 2 or 3 patients). The stenting was tried in one of group 1 and in three of group 2 or 3 patients only to fail. The initial patency rates were 95% (group 1), 89% (group 2) and 65% (group 3), respectively and were significantly different (p = 0.001). Further, the six month patency rates were 93% (group 1), 83% (group 2) and 50% (group 3), respectively, and were similarly significantly different (p = 0.001). Both the initial and six month patency rates in the IVCS patients (without thrombosis or with fresh thrombosis), were significantly greater than the patency rates of IVCS patients with non-fresh thrombosis.


CONCLUSIONS
From the cases examined, the study suggests that endovascular treatment of IVCS, with or without thrombosis, is effective.
Lou
Wen-Sheng
WS
Department of Interventional Radiology, Nanjing First Hospital, China, (Affiliated to Nanjing Medical University), Nanjing 210006, China.
Gu
Jian-Ping
JP
He
Xu
X
Chen
Liang
L
Su
Hao-Bo
HB
Chen
Guo-Ping
GP
Song
Jing-Hua
JH
Wang
Tao
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D002404:Catheterization; D003251:Constriction, Pathologic / Q000628:therapy; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007084:Iliac Vein / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents; D017131:Thrombectomy; D014654:Vascular Patency; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*