The "iliac vein compression syndrome" and lower limb vascular access for hemodialysis

A chronic renal failure patient requiring an access vein for hemodialysis underwent an a-v shunting procedure in the left leg. Post operative proliferating edema of the limb warranted further investigation and iliac vein obstruction syndrome was discovered which existed occulty until venous insufficiency was precipitated by the construction of the a-v shunt. Ilio-caval by-pass graft was capable of correcting the high venous pressure and ensuring the patency of the a-v shunt. This occult syndrome appears to be present in a high precentage of autopsy findings and occurs predominantly on the left side in young females. It is proposed that this high risk groups undergo radionuclide venography before any vascular procedure is undertaken in order to ensure a patent iliac vein.