title: Iliofemoral Venous Thrombosis Mainly Related to Iliofemoral Venous Obstruction by External Tumor Compression in Cancer Patients.
abstract: BACKGROUND
  To study iliofemoral venous thrombosis related to iliofemoral venous obstruction in cancer patients.
  
  
  METHODS
  In this case series study, 829 cancer patients were surveyed for iliofemoral obstruction/thrombosis within 10 years. The criteria for inclusion were: (1) presence of unilateral lower-extremity swelling; (2) computed tomography (CT) scans showing a tumor with external compression of the iliac or femoral vein, and (3) duplex ultrasound scans showing venous thrombosis or venous flow insufficiency over a femoral vein or saphenous vein.
  
  
  RESULTS
  Sixty-three patients (8%) developed an iliofemoral venous obstruction. The presence of iliofemoral venous thrombosis was detected in 21 of these patients (33%). The rate of iliofemoral venous thrombosis was significantly higher in patients with an invasion of the inguinal region, D-dimer levels >3,000 ng/ml, gastrointestinal cancer, or invasion of the inguinal lymph nodes. However, none of our patients with iliofemoral venous thrombosis had a detection of iliofemoral venous obstruction. Improved lower-extremity swelling was reported in 84% of the patients following combination therapy involving low-molecular-weight heparin (LMWH) and systemic therapy.
  
  
  CONCLUSIONS
  Patients with an iliofemoral venous thrombosis mainly had iliofemoral venous obstruction by external tumor compression. Combination therapy with LMWH and systemic therapy were mandatory for these patients.
authors.affiliation: Division of Hemato-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Tzu-Yao
authors.initials: TY
authors.lastname: Liao
authors.affiliation: Division of Chinese Acupuncture and Traumatology, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Hui-Ching
authors.initials: HC
authors.lastname: Hsu
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Min-Sheng
authors.initials: MS
authors.lastname: Wen
authors.affiliation: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Juan
authors.affiliation: Division of Hemato-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yu-Hsin
authors.initials: YH
authors.lastname: Hung
authors.affiliation: Division of Hemato-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chuang-Chi
authors.initials: CC
authors.lastname: Liaw
keywords: Computed tomography; D-dimer; Deep vein thrombosis; Duplex ultrasound; Iliofemoral obstruction; Thrombosis