Stent Implantation In Treatment Of Iliac Vein Compression Syndrome And The Discussion With Contralateral Lower Extremity Deep Venous Thrombosis

ObjectiveTo investigate the effect of complete stent expansion of the opening of the contralateral iliac vein on the formation of contralateral iliofemoral venous thrombosis in the course of treatment of iliac vein compression syndrome after stent placement.MethodsDuring January 2014 to December 2016,a total of 354 cases of patients with iliac vein compression syndrome were included in the study who received iliac vein stent implantation in our center,among which there were 216 patients with non-thrombotic stenosis,121 patients with secondary thrombosis,and 17 patients with post-thrombotic syndrome.All patients underwent balloon dilatation and stent placement of iliac vein lesions.For patients combined with lower extremity deep venous thrombosis,inferior vena cava filter implantation + catheter directed thrombolytic therapy were conducted in advance,iliac vein stent implantation was performed after thrombolysis.The general information,follow-up data and intraoperative angiographic data of all patients were collected and analyzed retrospectively.ResultsA total of 84 cases of patients underwent stent expansion of the opening of the contralateral iliac vein since lesions were found to be located at the junction of the iliac vein,among which 11 cases of patients occurred contralateral iliofemoral venous thrombosis after operation,corresponding onset time ranged 3-55 days postoperatively,with a mean disease time of(23.25±17)days.Meanwhile,there were 11 cases of patients received catheter directed thrombolytic therapy after protective inserting inferior vena cava filter,thrombus was completely dissolved after surgery.There were no serious complications such as death,pulmonary embolism and hemorrhage during the treatment.All 11 patients were followed up from 12 months to 24 months,with a mean follow-up period of(18±4)months.During the follow-up period,lower extremity deep venous angiography confirmed that the blood flow was smooth and there was no recurrence of thrombosis.ConclusionsThe venous function of the lower extremity was significantly improved after the stenting of the iliac vein compression syndrome.For patients with axillary venous stenosis who were completely covered on the contralateral side when the iliac vein stent was implanted,BMI too large,contralateral varicose veins,presence of primary DVT,low INR and smoking were risk factors for contralateral DVT after stent implantation.