scholarly journals Absence of right common iliac vein causing suprapubic and scrotal varices in a young athletic male

2021 ◽  
Author(s):  
Saad Balamane ◽  
Peter Brown ◽  
David Zelt ◽  
Michael Yacob
Keyword(s):  
Iliac Vein ◽  
Common Iliac Vein

May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

Endovascular repair of a spontaneous ilio-iliac fistula presenting as pulmonary embolism

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 246-250 ◽  
Author(s):  
Melas ◽  
Saratzis ◽  
Abbas ◽  
Sarris ◽  
Saratzis ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Endovascular Repair ◽  
Therapeutic Option ◽  
Artery Aneurysm ◽  
Iliac Vein ◽  
Massive Pulmonary Embolism ◽  
Long Term Results ◽  
Common Iliac Vein ◽  
Iliac Artery Aneurysm ◽  
Common Iliac Artery Aneurysm

Spontaneous rupture of a common iliac artery aneurysm into the common iliac vein is a rare phenomenon. We report the case of a 68 year old man admitted with acute cardiac failure and massive pulmonary embolism as a complication of a spontaneous ilio-iliac fistula, secondary to aneurysmal rupture. The aneurysm was successfully excluded using an aorto-uni-iliac stent graft. No complications were noted at 9 months follow-up. Arteriovenous fistulae should be considered in patients with aortic or iliac aneurysms who develop a pulmonary embolism or symptoms of venous congestion. Endovascular repair of these pathologies is a feasible therapeutic option; however long term results remain unknown.

A new treatment paradigm for phlegmasia cerulea dolen: Single stage endovascular pharmacomechanical thrombectomy with venoplasty and stenting

2020 ◽  
pp. 026835552097727
Author(s):  
GuangMing Tan ◽  
Bryan PY Yan
Keyword(s):  
Clinical Success ◽  
Treatment Algorithm ◽  
Clinical Success Rate ◽  
Iliac Vein ◽  
Single Stage ◽  
Bleeding Complications ◽  
Common Iliac Vein ◽  
Period 2 ◽  
Treatment Paradigm ◽  
Iliac Vein Compression

Background Phlegmasia Cerulae Dolen (PCD) is potentially a lethal disease but there is currently no established treatment algorithm for it. The aim of this study was to assess the safety and effectiveness of single stage endovascular pharmacomechanical thrombectomy with venoplasty and stenting in the treatment of PCD. Method This was a retrospective single centre observational study of consecutive patients who underwent endovascular intervention for the treatment of PCD between June 2016 and March 2020. Clinical and procedural details were recorded. Procedural and clinical success rate, procedural complications, and 30 days mortality were reported. Result 11 patients were treated during the study period. 2 (18.2%) had active malignancy. 63.6% were uncomplicated PCD on presentation. Common iliac vein compression or stenosis were demonstrated in all patients. Venous stents were implanted in all cases and procedures were successful in all cases. All patients had symptoms improvement at 72 hours post procedure. Other than 2 major bleeding complications, there was no other adverse event. The 30 days mortality was 18.2%. Active malignancy and the presence of anaemia were significantly associated with major complications. Conclusion Single stage endovascular thrombectomy and stenting was effective and safe in the treatment of patients with PCD. Common Iliac vein compression was a common underlying cause of PCD.

scholarly journals Rating the incidence of iatrogenic vascular injuries in thoracic and lumbar spine surgery as regards the approach: A PRISMA-based literature review

2021 ◽  
Author(s):  
Alice Giotta Lucifero ◽  
Cristian Gragnaniello ◽  
Matias Baldoncini ◽  
Alvaro Campero ◽  
Gabriele Savioli ◽  
...  
Keyword(s):  
At Risk ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Iliac Vein ◽  
Lumbar Spine Surgery ◽  
Common Iliac Vein ◽  
Suture Repair ◽  
Vascular Injuries ◽  
Mesh Terms ◽  
Thoracic And Lumbar Spine

Abstract Purpose To assess the rate, timing of diagnosis, and repairing strategies of vascular injuries in thoracic and lumbar spine surgery as their relationship to the approach. Methods PubMed, Medline, and Embase databases were utilized for a comprehensive literature search based on keywords and mesh terms to find articles reporting iatrogenic vascular injury during thoracic and lumbar spine surgery. English articles published in the last ten years were selected. The search was refined based on best match and relevance. Results Fifty-six articles were eligible, for a cumulative volume of 261 lesions. Vascular injuries occurred in 82% of instrumented procedures and in 59% during anterior approaches. The common iliac vein (CIV) was the most involved vessel, injured in 49% of anterior lumbar approaches. Common iliac artery, CIV, and aorta were affected in 40%, 28%, and 28% of posterior approaches, respectively. Segmental arteries were injured in 68% of lateral approaches. Direct vessel laceration occurred in 81% of cases and recognized intraoperatively in 39% of cases. Conclusions Incidence of iatrogenic vascular injuries during thoracic and lumbar spine surgery is low but associated with an overall mortality rate up to 65%, of which less than 1% for anterior approaches and more than 50% for posterior ones. Anterior approaches for instrumented procedures are at risk of direct avulsion of CIV. Posterior instrumented fusions are at risk for injuries of iliac vessels and aorta. Lateral routes are frequently associated with lesions of segmental vessels. Suture repair and endovascular techniques are useful in the management of these severe complications.

Dimensional disparity between duplex and intravascular ultrasound in the assessment of iliac vein stenosis

2021 ◽  
pp. 1358863X2110036
Author(s):  
Seshadri Raju ◽  
William Walker ◽  
Chandler Noel ◽  
Riley Kuykendall ◽  
Thomas Powell ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Venous Pressure ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Systematic Bias ◽  
Cross Sectional ◽  
External Iliac Vein ◽  
The Difference ◽  
Vein Stenosis ◽  
Linear Regressions

Minimum iliac vein caliber necessary to maintain normal peripheral venous pressure can be derived by the Poiseuille equation. Duplex was compared to intravascular ultrasound (IVUS) in the assessment of iliac vein stenosis in this single center retrospective study. Parallel IVUS and duplex caliber data for common iliac vein (CIV) and external iliac vein (EIV) in 382 limbs were separately compared. One or both segments were stenotic by IVUS criteria in 213 limbs. Neither segment was stenotic by IVUS in 22 limbs. Bland–Altman analyses and Passing–Bablok linear regressions were used. Duplex calibers were dimensionally smaller than corresponding IVUS images of CIV and EIV segments in Bland–Altman comparison by a mean of 54 mm2 and 34 mm2, respectively. Passing–Bablok regression suggested the difference was due to a systematic bias and not proportional. Duplex yields a smaller cross-sectional image of CIV and EIV compared to IVUS. Duplex is not a reliable diagnostic test for iliac vein stenosis.

Abstract 241: Piggyback and Horseshoe Balloon Catheter Models for Simultaneous Thrombolysis and Venous Angioplasty in Acute Ileofemoral Venous Thrombosis After IVC Filter Insertion

2012 ◽  
Vol 32 (suppl_1) ◽  
Author(s):  
Mark Arokiaraj ◽  
Luis Guerrero ◽  
Robert Levine ◽  
Igor Palacios
Keyword(s):  
Venous Thrombosis ◽  
Balloon Catheter ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Ivc Filter ◽  
Vein Thrombosis ◽  
Internal Iliac ◽  
Filter Insertion ◽  
Venous Angioplasty ◽  
Side Port

Background: To investigate the potential role of balloon mediated thrombolysis and venous angioplasty in acute ileofemoral thrombosis and to develop novel balloon catheter models for the same purpose. Methods: 2 patients and 1 patient on followup with extensive acute ileofemoral and popliteal vein thrombosis and partially extending into the inferior venacava (IVC) with diffuse swelling of lower limb and gluteal region were studied. The second patient stopped anticoagulation and presented with ileofemoral thrombosis in contralateral limb on followup. In both patients Gunther Tulip (Cook) IVC filter was placed. A 5F Multipurpose catheter with sideholes was placed in common iliac vein bifurcation and thrombolysis was done for 18 hours with streptokinase at 5000U/hr. Post thrombolysis IVC angiogram showed mild recanalisation of left common iliac veins leaving a stump. On the next day, the left common iliac vein was cannulated through a 5F Torcon catheter and a Terumo 035 J tipped wire was advanced through the clots. A 5cm x 4mm peripheral balloon was advanced and balloon directed 24 hour thrombolysis with streptokinase was done at 5000U/hr. The balloon was pulled back and multiple serial dilatations were done in femoral, internal iliac and common iliac veins. In both patients thrombolysis was started on the third day after the onset of symptoms. Results: Post procedure the venous channels were opened and were draining adequately. Limb edema subsided and there was no bleeding or embolic complications. Both patients are on oral anticoagulation and now on follow-up for 8 months being asymptomatic at present. Based on these interventions two novel balloon models to thrombolyse and to perform venous angioplasty simultaneously in a single procedure was developed. The first is a piggyback model which has a side port attached to the shaft of the balloon (5cm length and 4mm breath). The other model is a horse shoe balloon catheter which has a 14cm long and 4mm wide compliant balloon with 0.75mm diameter side port for thrombolysis till the balloon tip and on cross section gives a horse shoe appearance. Conclusion: Balloon mediated thrombolysis and venous angioplasty after IVC filter insertion is useful and novel balloon catheter models may be used in ileofemoral venous thrombosis.

scholarly journals A rare case of May-Thurner-like syndrome in an elderly lady

2014 ◽  
Vol 1 (2) ◽  
pp. 19
Author(s):  
Kapil Sahnan ◽  
Chris Pui Yan Yee ◽  
Robert Hywel Thomas ◽  
Kaji Sritharan
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Imaging Modality ◽  
Lumbar Vertebrae ◽  
Kidney Injury ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Extrinsic Compression ◽  
Duplex Imaging

An elderly lady presented with decreased mobility, sputum production and intermittent confusion. She was treated for chest sepsis, fast atrial fibrillation, and acute kidney injury, and also noted to have a swollen left leg. Venous duplex imaging showed extensive thrombus within the left common iliac, left external iliac and left common femoral veins. A CT Venogram showed compression of the left common iliac vein between an osteophyte at L5 and a calcified ipsilateral common iliac artery. It also showed a pelvic kidney with an extra renal pelvis and large renal cyst which was indirectly contributing to venous compression by splinting the left iliac artery. A decision was made after discussion at the Vascular MDT that the patient was not fit enough for surgery and to manage her medically with anticoagulation. Discussion: Proximal DVT’s are rarer than distal thrombosis, but have similar causes. One of the rarer causes of proximal DVT is May-Thurner syndrome and its variants known collectively as non-thrombotic iliac vein lesions. May-Thurner originally described DVT formation caused by extrinsic compression of the left common iliac vein between the overriding contralateral (right) common iliac artery and adjacent lumbar vertebrae. The best imaging modality is a CT Venogram. Duplex ultrasonography can be used, although it can be difficult to visualize the iliac veins. The mainstay of management is surgical thrombectomy, or thrombolysis, followed by stenting of the affected vessel. However, if intervention is not appropriate, then it can be managed medically with anticoagulation. 

scholarly journals Considerations on the caliber of the internal iliac vein

2015 ◽  
Vol 21 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Oana Popa ◽  
P. Bordei ◽  
C. Ionescu ◽  
D.M. Iliescu
Keyword(s):  
Iliac Vein ◽  
Statistical Distribution ◽  
Common Iliac Vein ◽  
Internal Iliac Vein ◽  
Distribution Of Values ◽  
Internal Iliac ◽  
The Common ◽  
The Right

Abstract The diameter at the origin of the internal iliac vein was found between 4.7 to 9.9 mm; for the right internal iliac vein between 4.7 to 9.7 mm; the statistical distribution groups value in ascending order being as follows: 4.7 to 5.5 mm: 4 cases (22.22% of cases); 6.9 to 7.8 mm: 6 cases (33.33% of cases); 8.4-8.8 mm: 4 cases (22.22% of cases); 9.1 to 9.7 mm: 4 cases (22.22% of cases). The diameter at the origin of the left internal iliac vein was between 4.8 to 9.9 mm, while the distribution statistics on groups of values, in ascending order, being as follows: 4.8-5.2 mm: 4 cases (22.22 % of cases); 6.8-7.1 mm: 8 cases (44.44% of cases); 8.3 to 9.9 mm: 6 cases (33.33% of cases). The diameter at the end of the internal iliac vein was between 5.9 to 10.2 mm; the diameter at the end of the right internal iliac vein was between 6.1 to 10.2 mm, the statistical distribution of values groups in ascending order being follows: 6.1 to 7.5 mm: 6 cases (33.33% of cases); 8.4 to 8.7 mm: 8 cases (44.44% of cases); 9.3 to 10.2 mm: 4 cases (22.22% of cases). The diameter at the end of the left internal iliac vein was between 5.9 to 9.9 mm, while the distribution statistics on groups of values in ascending order being as follows: 5.9 to 6.2 mm: 4 cases (22.22 % of cases); 7 to 7.6 mm: 3 cases (16.67% of cases); 8.3-8.4 mm: 5 cases (27.28% of cases); 9.1 to 9.9 mm: 6 cases (33.33% of cases). Comparing the common iliac vein caliber of the two, right and left, we found that in 10 cases (55.56% of cases), the right internal iliac vein has a greater diameter than the left one by 0.3 mm. In 8 cases (44.44% of cases), the left internal iliac vein has a larger diameter than the right one with 0.1-0.6 mm; between the two values there is a difference of 0.5 mm

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