May-Thurner syndrome complicated by acute iliofemoral vein thrombosis: helical CT venography for evaluation of long-term stent patency and changes in the iliac vein.
OBJECTIVE
The purpose of this study was to use CT venography to evaluate long-term patency and changes in the iliac veins after stent placement for acute iliofemoral vein thrombosis due to May-Thurner syndrome.


METHODS
From December 1999 to July 2007, 30 patients (22 women, eight men; age range, 30-78 years; mean, 56.7 years) with acute iliofemoral vein thrombosis due to May-Thurner syndrome diagnosed with CT venography were treated with catheter-directed thrombolysis and stent placement. The patients underwent follow-up CT venography at variable intervals according to clinician discretion. The primary objective was to determine the primary patency of the stented segment. The secondary objective was to investigate the potential role of CT venography by analyzing the morphologic features and interval changes in stented iliac veins. Cumulative primary and secondary stent patency rates were calculated by Kaplan-Meier estimation.


RESULTS
Four stent occlusions and one stent collapse were found at the first follow-up CT venographic examination within 1 year (mean duration, 129.3 days) after treatment. One stent occlusion and one stent collapse were managed successfully. The primary and secondary patency rates were 83.3% and 90% 1 and 5 years after treatment. The morphologic features of the common iliac vein did not affect stent patency or expanded stent diameter. During sequential CT venographic follow-up, no new in-stent stenosis or occlusion was found.


CONCLUSIONS
Iliac stents placed for May-Thurner syndrome with acute thrombosis had excellent long-term patency. Restenosis or occlusion occurred early, and initial luminal patency was well maintained during long-term follow-up.
Jeon
Ung Bae
UB
Department of Radiology, Medical Research Institute, Yangsan Hospital, Pusan National University, Pusan, Korea.
Chung
Jin Wook
JW
Jae
Hwan Jun
HJ
Kim
Hyo-Cheol
HC
Kim
Sang Joon
SJ
Ha
Jongwon
J
Park
Jae Hyung
JH
D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic; D003287:Contrast Media; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging*; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging*; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications*; D010690:Phlebography / Q000379:methods*; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D012008:Recurrence; D015607:Stents; D013577:Syndrome; D036542:Tomography, Spiral Computed / Q000379:methods*; D016896:Treatment Outcome; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000628:therapy
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide