Endovascular management of iliac vein occlusive disease

Iliac vein occlusive disease presents with either acute or chronic symptoms, both of which can be managed with endovascular techniques. This report summarizes our experience in a small cohort of patients undergoing percutaneous treatment of iliac vein occlusive disease. Six women and one man with occlusive lesions in the iliac veins are included in this report. All patients reported leg pain and swelling, involving the right leg in one and the left leg in six. Symptoms were acute in one patient and chronic in six. Two patients presented with a chronic stasis ulcer. All patients with chronic symptoms were treated with self-expanding stents deployed across the occlusive lesion. The patient with acute symptoms was treated successfully with thrombolysis, which uncovered a fixed stenosis that was then stented. Post-procedure follow-up with duplex scanning was used for vein patency. No significant complications occurred. All patients reported symptomatic improvement, with four having complete resolution. Duplex scanning showed all treated venous segments to be patent at a mean of 12 months. Recanalization of obstructed iliac vein segments can be performed successfully and leads to improvement in pain and edema in the affected limb. Midterm patency rates are excellent.