The Clinical Analysis Of Diagnosis And Treatment Of Iliac Vein Compression Syndrome

Objective:To evaluate the effectiveness of treatment of iliac veincompression syndrome (IVCS).Methods: To analyze the clinical data of153cases with IVCS beingtreated in vascular surgery of our hospital from November of2008to Julyof2011. Majority of the153IVCS patients aged over40-year-old, whichaccounts for93%, with a male-to-female ratio of0.65:1. All the153IVCScases affects the left lower extremity vein, including63chronic venousinsufficiency (CVI) cases, which accounts for41.2%of the total cases and9.8%of the same period CVI cases, and90deep venous thrombosis(DVT) cases,which accounts for58.8%of the total cases and90.9%of the same periodDVT cases. The diagnosis was made through anterograde venography and colordoppler ultrasound examination. At last, the definite diagnosis was madeby the catheterization of femoral vein and iliac vein venography. In thewhole group,28patients only took the balloon angioplasty, which accountsfor18.3%, while both balloon angioplasty and coronary stenting was donefor48patients, which accounts for31.4%. Twelve patients took the expectanttreatment because of the iliac vein stenosis is less than50%, which accountsfor7.8%. Sixty-five patients took the expectant treatment because of theirrefusal to take the coronary stenting or some economic reasons, whichaccounts for42.5%.Results: The success ratio of the interventional therapy for all the cases is100%. One hundred and twenty-two cases were followed up for4-40months with the average of21.48±7.55months. Forty-eight patients whoreceived both balloon angioplasty and coronary stenting had improvedsignificantly and45of them were followed up for4-40months with the averagemonth21.40±7.58. The symptom of the43patients had alleviated completely.Recurrence of thrombus and stenting occlusion was occurred in two patientswho were back from long-distance travel. Twenty-eight patients who receivedonly balloon angioplasty had also improved significantly,25of them werefollowed up for5-38months with the average month21.25±7.22. The symptomof the22patients had resolved while bloating were still found in the lowerextremity of three patients. For the twelve patients who took the expectanttreatment because of the iliac vein stenosis is less than50%, the symptomhad resolved as well. Five of them were followed up for6-37months withthe average month22.30±7.35while three of them had improved basicallyand two still suffered from bloating in the lower extremity.In the65patients who took the expectant treatment because of widespread pathologicalchanges or other reasons,47patients were followed up for5-38months withthe average month22.50±7.55, the symptoms of fifteen patients wererelieved, recurrence of thrombus were occurred in seven cases and bloatingin the lower extremity were still happened in32cases.Conclusion: Acquired factors, anatomic abnormalities and many otherfactors may cause iliac vein compression syndrome (IVCS). The key factorwhich may cause deep venous thrombosis (DVT) is IVCS. The main tool todiagnose IVCS is iconography and the catheterization of femoral vein and iliac vein venography is the “gold standard". At present, theinterventional therapy, which has the advantages of safe, minimally invasiveand easy to operate, is the principal method. The short-term curative effectof interventional therapy is satisfactory while the long-term effect stillneeds to be researched and observed.