Iliac Vein Compression Syndrome & Pelvic Venous Insufficiency
10-15% of patients may not realize as much relief from their signs or symptoms of venous insufficiency as they hoped for or expected. Additionally, 10% of our new patients may have had previous vein procedures such as vein stripping or endovenous vein closures when they present to our practice for second opinion. Ultrasound evaluation of these patients often reveals only short segments of leaking veins which are not significant enough to account for their persistent or recurrent vein related symptoms or clinical signs. A potential cause of recurrent vein problems after previous procedures which has received much attention in the vein specialty world is iliac vein compression syndrome (IVCS). IVCS may occur as the result of arterial compression of one of the main outflow (iliac) veins, leading to increased pelvic and lower extremity venous pressure. This increased pressure can lead to failure of previous vein treatments such as vein stripping or the more current endovenous ablation techniques. Since the iliac veins are deep in the pelvis, they are not easily examined with traditional techniques such as transcutaneous pelvic ultrasound, CT scan or Magnetic Resonance Imaging. However, intravascular ultrasound (IVUS), a minimally invasive, catheter based ultrasound technique, allows direct examination of the more proximal pelvic veins from within the actual blood vessels.
Signs & Symptoms
Large varicose veins from the groin, vulva, or gluteal fold
Leg swelling (one or both legs), one leg might be larger than the other.
Leg Ulcers or stasis dermatitis.
Pain in pelvis & abdomen with squatting or crouching.
Painful intercourse (during or after) and increased pain with menstruation
Pain in buttock, posterior thigh or knee with prolonged sitting or standing.