ObjectiveTo investigate the research progress of diagnosis and treatment of iliac vein compression syndrome (IVCS) so as to find the optimal diagnosis and treatment method in clinic. MethodLiterature about etiology, pathophysiology, clinical manifestations, diagnosis and treatment of IVCS in recent years was reviewed. ResultsIVCS was one of the pelvic vein obstructive diseases. The compression of left common iliac vein by right common iliac artery was more common in clinic, and it could also cause partial or complete occlusion of the iliac vein due to other external pressures. Clinical manifestations mainly included venous pain, edema, varicose veins, venous ulcer, skin pigmentation, and other skin nutritional changes. The examination methods mainly included color Doppler ultrasound, computed tomography venography, magnetic resonance venography, intravascular ultrasound, and venography. The treatment method had been changed from the original open venous reconstruction to intravascular treatment. Endovascular treatment was included thrombolysis, thrombectomy, percutaneous mechanical thrombectomy, balloon angioplasty, and endovascular stent treatment or combination treatment according to whether they were combined with iliac-femoral venous thrombosis or not. ConclusionBased on the existing researches, intravascular ultrasound is the first choice to diagnose and guide the intravascular treatment, and iliac vein stenting is an effective method for the treatment of IVCS with a good long-term patency and obvious symptom improvement.
ObjectiveTo compare the improvement of clinical symptoms and patency of stents in patients with left and right non-thrombotic iliac vein compression syndrome (NIVCS) after endovascular stent therapy. MethodsThe clinical data of patients with NIVCS admitted to the First Affiliated Hospital of Chongqing Medical University from January 2016 to January 2021 were analyzed retrospectively. The venous clinical severity score of the patients’ veins before therapy and on month 12 after therapy was analyzed. At the same time, the patencies of stents on month 1, 3, 6, and 12 after stenting were also analyzed. ResultsA total of 164 patients with NIVCS were collected, including 144 left NIVCS and 20 right NIVCS. The surgical technique success rate of endovascular stent therapy was 100% (164/164). There was no statistical difference of the venous clinical severity score between the patients with left and right NIVCS on month 12 after therapy (t=1.265, P=0.208), but the venous clinical severity score of left and right NIVCS patients on month 12 after therapy were lower than those before therapy (t=27.534, P<0.001; t=10.047, P<0.001). The accumulative one-stage stent patency rate on month 12 after therapy was 96.5% and 94.7% in the patients with left and right NIVCS, respectively (χ2=0.160, P=0.689). After the stent was fully supported and completely covered the extent of the lesion, the short-term (within 12 months) stent patency rates of the patients with different compression site of the iliac vein, as well as type, diameter, and length of stent placement had no statistical differences (P>0.05). ConclusionFrom the results of this study, whether left NIVCS or right NIVCS, endovascular stent therapy is safe and effective.