Iliac artery stenosis complicating iliac vein stenting in a patient with a history of radiation and cancer: case report and literature review.
Radiation-associated venous stenosis is not as well described in the literature as radiation-induced arteritis and is mainly limited to case reports. Treatment of radiation-associated venous stenosis may be challenged by the patient's comorbidities, such as cancer, compressive tumor, or secondary thrombophilia. The endovascular treatment of venous occlusions is now widespread and is usually the preferred modality. This is especially true for lesions of the iliac venous system. However, the development of arterial stenosis after iliac vein stenting has not previously been reported in the literature as a complication. We present a case of left common iliac artery stenosis developing immediately after left iliac vein stenting for stenosis that developed secondary to extensive pelvic surgery and targeted radiotherapy. This case report illustrates the challenges in treating an iliac vein stenosis in a hostile pelvis, reports a previously unidentified complication of iliac vein stenting, documents the first reported cases of using kissing balloons in an artery and adjacent venous segment, and reviews the literature in regard to iliac vein and inferior vena cava stenting in patients with a history of neoplasm and radiation treatment.
Division of Vascular Surgery, University of Texas San Antonio Medical Center, San Antonio, TX.
Christopher J
CJ
Busken
Division of Vascular Surgery, Baylor University Medical Center, Dallas, TX.
Bradley R
BR
Grimsley
Division of Vascular Surgery, Baylor University Medical Center, Dallas, TX. Electronic address: williash@Baylorhealth.edu.
William P
WP
Shutze
D000800:Angioplasty, Balloon / Q000009:adverse effects* / Q000295:instrumentation*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003110:Colonic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000532:radiotherapy*; D003251:Constriction, Pathologic; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007084:Iliac Vein / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D010690:Phlebography / Q000379:methods; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D015607:Stents; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*