RESUMO
Iliac vein stenosis (IVS), known as iliac vein compression syndrome, refers to a series of diseases caused by iliac vein compression or intraluminal adhesions leading to lower extremity vein or pelvic vein drainage disturbance and other clinical manifestations which is quite common in vascular surgery. The vast majority of patients with symptoms of chronic venous insufficiency (CVI) have IVS. In clinical work, IVS does not typically appear as a single symptom, while often combining with other lesions, such as varicose veins of the lower extremities, skin pigmentation, ulcer formation. Studies on its aetiology and epidemiology have found a mean age of onset of 40 years, the age of onset in females is lower than that in males, and the average of stress in females is significantly higher than that in males. Typical IVS occurs mainly in the left lower extremity in young women of reproductive age, but exceptions remain. In summary, the importance of the diagnosis of IVS in clinical practical work can be seen. CVI is a general term for all diseases that affect the morphology and function of the venous system. Compared with chronic venous disease (CVD), CVI include venous system abnormalities without symptoms or signs. Thus, it more accurately describes the diagnosis and treatment of IVS that requires clinical guidance, so its concept is quoted. With the development and advancement of medical imaging, more and more techniques provide help in the diagnosis and treatment of IVS. Therefore, professionals in various specialties have made relevant studies about the benefits and drawbacks of imaging techniques for diagnosis, treatment modalities, and prognostic management of this disease, in order to improve the diagnostic efficacy. Consequently, this review is focused on the current situation of the diagnosis and treatment of IVS under multi-modal imaging, hoping to provide choices of medical imaging technologies for the different states, and to find a better and personalized plan for patients.
RESUMO
A case of radiation-induced venous stenosis (phlebitis) after pelvic irradiation in a patient with prostate cancer is reported. Progressive swelling of both lower limbs developed due to bilateral external iliac vein stenosis. Conservative treatment with new oral anticoagulants and elastic stockings was conducted with clinical improvement of symptoms. Serial duplex scanning with trimestral frequency reveals no other progression of stenosis and the patient is well 2 years after diagnosis. Lack of data in the current literature makes management of this disease problematic.
RESUMO
OBJECTIVE: Compression of the left common iliac vein between the right common iliac artery and the vertebrae is known to be associated with the occurrence of left iliofemoral deep vein thrombosis (DVT). In this study, we described the variability in vascular anatomy of the common iliac veins and evaluated the relationship between the degree of iliac vein compression and the presence of DVT using the data from surgeries for gynecologic cancer. METHODS: The anatomical variations and the degrees of iliac vein compression were determined in 119 patients who underwent systematic para-aortic and pelvic lymphadenectomy during surgery for primary gynecologic cancer. Their medical records were reviewed with respect to patient-, disease-, and surgery-related data. RESULTS: The degrees of common iliac vein compression were classified into three grades: grade A (n=28, 23.5%), with a calculated percentage of 0%-25% compression; grade B (n=47, 39.5%), with a calculated percentage of 26%-50% compression; and grade C (n=44, 37%), with a calculated percentage of more than 50% compression. Seven patients (5.9%) had common iliac veins with anomalous anatomies; three were divided into small caliber vessels, two with a flattened structure, and two had double inferior vena cavae. The presence of DVT was associated with the elevated D-dimer levels but not with the degree of iliac vein compression in this series. CONCLUSION: Although severe compression of the common iliac veins was frequently observed, the degree of compression might not be associated with DVT in surgical patients with gynecologic cancer. Anomalous anatomies of common iliac veins should be considered during systematic para-aortic and pelvic lymphadenectomy in the gynecologic cancer patients.