The Clinical Analysis Of The Diagnosis And Treatment In Iliac Vein Compression Syndrome Complicated With Deep Vein Thrombosis

Objective:To discuss the diagnosis and treatment of iliac vein compressionsyndrome(IVCS) complicated with deep vein thrombosis(DVT).Methods:The clinical data of 156 cases with IVCS complicated with DVTtreated in vascular surgery of our hospital from August 2011 to July2014 was analyzed. Majority of the 156 patients aged over 40-year-old,which accounts for 85.3%, with a male-to-female ratio of 0.66:1.Themain symptoms of all patients were swelling and pain in the lowerextremity.One hundred and fifty-two cases occurred on the leftside,and the other 4 cases were on the right side.The duration ofsymptoms were 8 hours to 31 days, with the average of 6.35±5.74 days.There are 143 cases within 2 weeks,and 13 cases varing from 2 weeksto 31 days.There were 50 cases with iliofemoral deep venousthrombosis,and 106 cases with deep venous thrombosis in the total lowerextremity.The diagnosis of DVT was made through color dopplerultrasound examination.And the definite diagnosis of IVCS complicatedwith DVT were made by venography and the catheterization of femoralvein and iliac vein venography.In the whole group,2 patients only tookanticoagulant therapy because of their old thrombi.The other 154 patients took catheter-directed thrombolysis.Sixty-four patientstook both balloon angioplasty and coronary stenting,while 2 patientsonly took the balloon angioplasty.Ninety patients took the expectanttreatment. All the cases above took anticoagulant therapy.Results:One hundred and thirty-one cases, which accounts for 84.0%,werefollowed up for 3-27 months with the average of 9.34±5.31 months.Thesuccess ratio of the interventional therapy for all the cases is94.3%.Sixty-four patients who received both balloon angioplasty andcoronary stenting had improved significantly and 58 of them werefollowed up for 3-27 months with the average of 9.29±5.91 months.Recurrence of thrombus and stenting occlusion was occurred in twopatients who took medicine irregularly.The symptom of the 56 patientshad alleviated completely.Two patients who received only balloonangioplasty had also improved significantly.Both of them were followedup for 12 months.Seventy-one of the 90 patients who took the expectanttreatment were followed up for 3-24 months with the average of 9.45± 4.77 months.Forty-one patients had improved significantly.Recurrence of thrombus were occurred in 3 cases and bloating in the lowerextremity were still happened in 27 cases.Conclusion:The key factor which may cause DVT is IVCS. The principal methodsto diagnose DVT are D-dimer testing,color doppler ultrasoundexamination and anterograde venography.The “gold standard” for thediagnose of IVCS is femoral and iliac vein venography.Catheter-directed thrombolysis,and balloon angioplasty together withstent placement are an effective way for the treatment of IVCScomplicated with DVT.Anticoagulant therapy,which is the basis foranti-thrombotic therapy,should run through the whole process.