Have you undergone vein treatment yet still experience varicose veins, leg swelling or discomfort?
You’re not alone. Up to 15% of patients struggle with persistent symptoms. And 10% of our new patients have had previous procedures like vein stripping or endovenous ablation when they come to our practice for a second opinion.
A frequently overlooked cause of recurrent venous disease is iliac vein compression, sometimes referred to as May-Thurner-type compression. This occurs when the right common iliac artery compresses the left common iliac vein, restricting healthy outflow from the pelvis and left leg.
When this deep outflow pathway is narrowed, pressure can build in the pelvic and leg veins, contributing to persistent symptoms, varicose vein recurrence, and, in some patients, pelvic congestion syndrome.
Historically, these deep veins were difficult to evaluate in a routine outpatient setting. Fortunately, advances in ultrasound technology, along with specialized training, now allow us to assess this condition more accurately and noninvasively.
One key test is the iliac vein duplex ultrasound, which identifies findings that strongly correlate with clinically significant iliac vein compression.













