Endovascular Treatment for Symptomatic Iliac Vein Compression Syndrome: A Prospective Consecutive Series of 48 Patients

Background: We sought to assess the prevalence of iliac vein compression syndrome (IVCS) in patients with unilateral left lower limb chronic venous disease and evaluate the feasibility and effectiveness of endovascular treatment for IVCS. Methods: We conducted a prospective cohort study of 48 consecutive patients diagnosed with IVCS between December 2008 and May 2012. We divided the patients into 2 groups: thrombotic IVCS (n = 12) and nonthrombotic IVCS (n = 36). We evaluated the perioperative, 30-day, and 1-year outcomes of endovascular treatment. We estimated the stent patency rate using the KaplaneMeier method. Results: The prevalence of IVCS within our cohort was 14.8% (48/324). The technical success rate of the endovascular treatment was 95.8%. There was no death, pulmonary embolism, or contrast-induced nephropathy among the patients. The 1-year primary patency rate was 93.0%. There was no significant difference between the thrombotic and nonthrombotic IVCS groups (P = 0.156). Perioperative complications were minor and improved quickly. The median pain level recorded on a visual analogue scale declined from 4.5 to 1.2 (P < 0.05) in the thrombotic ICVS group and from 3.3 to 0.3 (P < 0.05) in the nonthrombotic ICVS group. The edema relief rates in the thrombotic and nonthrombotic ICVS groups were 81.8% and 58.5%, respectively. The cumulative recurrence free ulcer healing rate was 71.4% 12 months after treatment. Conclusions: IVCS is more common than previously thought among patients with unilateral left lower limb chronic venous disease. Endovascular therapy, a minimally invasive approach to treating venous lesions, is a feasible and effective treatment for left-sided IVCS and has a high technical success rate and an acceptable complication profile.