Chronic bilateral iliofemoral and vena caval postthrombotic occlusion

Abstract

Chronic inferior vena cava (IVC) obstruction can have a range of clinical presentations, from no symptoms, minimal lower extremity edema, and discomfort to more severe manifestations, such as genital varicosities, venous claudication, venous ulceration, and even hepatic or renal insufficiency. Percutaneous stenting of the iliocaval venous segment guided by intravascular ultrasound (IVUS) is presently the method of choice in the treatment of symptomatic chronic venous obstruction at this anatomical site. The endovenous procedure is minimally invasive, with low morbidity, long-term stent patency, a low rate of in-stent stenosis, and limited need for reinterventions. It results in sustained relief of limb symptoms, a high rate of healing of venous leg ulcers, substantial improvement of quality of life, and decreased disability.