J Korean Med Sci.  2004 Oct;19(5):729-734. 10.3346/jkms.2004.19.5.729.

Endovascular Management of Iliofemoral Deep Venous Thrombosis due to Iliac Vein Compression Syndrome in Patients with Protein C and/or S Deficiency

• Cho YP
• Ahn JH
• Choi SJ
• Han MS
• Jang HJ
• Kim YH
• Kim HJ
• Kwon TW
• Lee SG

• KMID: 1733517
• DOI: http://doi.org/10.3346/jkms.2004.19.5.729

Abstract

The purpose of this study was to evaluate the early outcome of endovascular management in patients with iliofemoral deep venous thrombosis (DVT) due to iliac vein compression syndrome (IVCS) and protein C and/or S deficiency. Between September 2000 and January 2003, catheter-directed thrombolysis was performed in 11 patients with a diagnosis of acute iliofemoral DVT: 7 with protein C and/or S deficiency and 4 without protein C and/or S deficiency. After thrombolysis, the diagnosis of IVCS was confirmed in 6 patients: 4 with protein C and/or S deficiency and 2 without protein C and/or S deficiency. Further intervention consisted of angioplasty and stent placement was performed. Four patients with IVCS and protein C and/or S deficiency were included in this study. The immediate technical and clinical success rates were 100% in all 4 patients. There were no complications or clinically detectable pulmonary emboli. This initial experience suggests that endovascular management of iliofemoral DVT due to IVCS in patients with protein C and/or S deficiency is safe and effective.

Keyword

Thrombolytic Therapy; Venous Thrombosis; Protein C Deficiency; Protein S Deficiency

MeSH Terms

Adult
Aged
Female
Humans
Iliac Vein
Male
Middle Aged
Plasminogen Activators/administration & dosage
Protein C Deficiency/*complications
Protein S Deficiency/*complications
Research Support, Non-U.S. Gov't
*Thrombolytic Therapy
Treatment Outcome
Urinary Plasminogen Activator/administration & dosage
Venous Thrombosis/*complications/*drug therapy

Figure

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  Fig. 1 A 75-yr-old female patient presents with a 10-day history of left leg pain and severe swelling extending up to the groin. Doppler ultrasound reveals acute thrombosis extending into the left common iliac vein. (A) In the prone position, ascending subtraction venogram demonstrates an acute thrombus extending into the common iliac vein. (B) After 47 hr of thrombolytic therapy, the vast majority of the thrombus has been disappeared; the underlying left common iliac vein stenosis becomes apparent. (C) After angioplasty and stent placement, final subtraction venogram shows complete resolution of iliac vein flow and no residual filling defect.

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