A Case of Isolated External Iliac Vein Compression Syndrome and the Role of Advanced Imaging

Abstract

<jats:p> Isolated external iliac vein compression syndrome is an uncommon cause of nonthrombotic venous stenosis that causes chronic venous hypertension leading to painful swelling, skin discoloration, and ulcer formation. We present a case of an 86-year old man with refractory lower extremity edema for several years who had been treated with diuretics and antibiotics without relief of symptoms. With the help of invasive and noninvasive imaging modalities, we were able to diagnose and manage isolated nonthrombotic left external iliac vein stenosis as a result of ipsilateral external iliac artery compression. </jats:p>

A Woman with Unilateral Leg Swelling

“…Symptomatic iliac vein compression typically presents with unilateral leg swelling, intermittent claudication, chronic ulceration, varicosities, deep venous thrombosis, and hyperpigmentation. 1,2 The most common mechanism is the right external and internal iliac arteries "sandwiching" the iliac vein, but ganglion and synovial cysts, bursitis, and pelvic masses are also culprits, and coagulopathies can also contribute. 3,4 The treatment of hemarthrosis includes ice packing, immobilization, arthrocentesis, management of underlying causes such as hemophilia, and surgery for refractory cases.…”