Case 23: Chronic Debilitating Leg Pain and Swelling, due to Iliac Vein Obstruction, Successfully Treated With Balloon Venoplasty With Iliac Vein Stenting

Authors: Tae An Choi ANP-BC & Back Kim MD FACC.
Heart Vein NYC, New York, New York


A 81 year-old female, suffering 30 year history of right leg swelling and pain, accompanied with right lower back and buttock pain, refractory to a long-term use of compression stocking and multiple Endovenous Laser Ablation treatments at local hospital. Venography with contrast injection from a 10 F Sheath in right common femoral vein was performed demonstrating a severe narrowing of right iliac vein (figure 1: Yellow arrow).

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Figure 1 Venogragraphy demonstrating a severe narrowing of right iliac vein (Yellow arrow)

The subsequent emanation with Intravascular Ultrasound (IVUS) confirmed severe iliac vein compression with significant luminal reduction (approximately 89%) of right Common Iliac Vein (CIV) and right External Iliac Vein (EIV), compared the  adjacent normal reference segment (figure 2).

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Figure 2 IVUS (Intravascular Ultrasound) confirming  severe iliac vein compression with significant luminal reduction (approximately 89%) of right Common Iliac Vein (CIV) and right External Iliac Vein (EIV), compared the  adjacent normal reference segment.

Balloon dilation with stent deployment was performed successfully. Subsequent IVUS showed a complete resolution of right common iliac vein compression by right common iliac artery (CIA) after iliac vein stent implantation (figure 3).  The resolution of iliac vein compression resulted in almost complete relief of her back, buttock and leg pain immediately. At follow-up 1 week after procedure, patient continued significant improvement of her symptoms and ultrasound showed patent stents.

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Figure 3 IVUS demonstrating the decompressed right CIV after stenting.

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