Iliac Vein Compression Syndrome in Spinal Cord Injury

ABSTRACT

OBJECTIVE: Iliac vein compression syndrome is a well-recognized anatomic variant that is associated with the development of symptomatic deep venous thrombosis (DVT) of the left iliac vein. However, its relation with DVT in spinal cord injury has not been established. The purpose of this study was to determine the relation between iliac vein compression syndrome and DVT in spinal cord injured patients. METHOD: Thirteen spinal cord injured patients diagnosed with DVT from January 2002 to December 2003 were evaluated. After ascending venography, the catheter-directed thrombolytic therapy and balloon angioplasty with stent insertion after 24 hours of thrombolytic therapy were done. RESULTS: Twelve of 13 patients showed that the left iliac vein was compressed by the right iliac artery, with thrombosis shown in the distal venous segment of the crossover point and had a collateral formation. All 12 patients had residual stenosis of left iliac vein in spite of the thrombolytic therapy. The unimpeded venous flow of iliofemoral veins was revealed after the balloon angioplasty with stent insertion. CONCLUSION: We suggested that the proper evaluation and management about iliac vein compression syndrome be considered when residual stenosis was persistent through the chemical dissolution in spinal cord injured patient with left iliac vein thrombosis.