Spontaneous Iliac Vein Rupture Due to May-Thurner Syndrome and Its Staged Management

Ingram, Michael; Miladore, Julia N.; Gupta, Alok; Maijub, John G.; Wang, Keisin; Fajardo, Andres; Motaganahalli, Raghu L.

doi:10.1177/1538574419831488

Cited by 7 publications

(8 citation statements)

References 8 publications

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“…Internal iliac vein reflux and collateral circulation formation are also independent risk factors for IVCS, which means that it is reasonable to consider both factors as common diagnostic factors for IVCS. The presence of internal iliac vein and collateral vessels in CTV scans not only represents pathological changes caused by long-term mechanical stenosis but also indicates the severity of IVCS 31,32 . The sensitivity and accuracy of the combined diagnostic method were higher than those of the iliac vein stenosis method (94.48% vs 83.44% [ P = 0.01] and 84.85% vs 78.03% [ P = 0.04]).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of the Iliac Vein Stenosis Percentage Combined With Indicators of Venous Reflux for Iliac Vein Compression Syndrome With Computed Tomography Venography

Yin¹,

Wang²,

Wei³

et al. 2022

J Comput Assist Tomogr

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ObjectivesTo identify a cutoff value of iliac vein stenosis in computed tomography venography (CTV) for assisting in the diagnosis of iliac vein compression syndrome (IVCS). Meanwhile, determining whether the inclusion of venous return and collateral imaging findings could further enhance the diagnostic performance.MethodsWe conducted a retrospective study on 264 patients suspected of IVCS who underwent both CTV and digital subtraction venography (DSV) from January 2016 to December 2020; they were assigned to either a control group (n = 101) or an IVCS group (n = 163) based on the DSV results. The narrowest anteroposterior diameter of the common iliac vein and the anteroposterior diameter of the distal end were measured to calculate the percentage of iliac vein stenosis. Receiver operating characteristic curve analysis was performed to determine the predictive accuracy of the percentage of iliac vein stenosis for IVCS and whether the inclusion of venous reflux indicators can further improve the diagnostic accuracy.ResultsWith respect to the DSV results, the area under the curve was 0.797 (P < 0.001). The best cutoff value was 46.67%, corresponding to a sensitivity of 83.44% and a specificity of 69.31% for predicting IVCS. Moreover, the combination diagnostic method had higher sensitivity and accuracy (94.48% vs 83.44% [P = 0.01] and 84.85% vs 78.03% [P = 0.04], respectively).ConclusionsThe best cutoff percentage of iliac vein stenosis to diagnose IVCS was 46.67% with CTV. The sensitivity and accuracy of the combined diagnostic method were higher than those of the iliac vein stenosis ratio diagnostic method.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Value of the Iliac Vein Stenosis Percentage Combined With Indicators of Venous Reflux for Iliac Vein Compression Syndrome With Computed Tomography Venography

Yin¹,

Wang²,

Wei³

et al. 2022

J Comput Assist Tomogr

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“…Conservative treatment is an option that is only applicable to hemodynamically stable patients. 21,34,38,39 Traditional laparotomy and surgical iliac vein repair is the most commonly used open surgical approach. Endovascular treatment of SIVR was first reported in 2003.…”

Section: Discussionmentioning

confidence: 99%

“…This makes it 1 of the common causes of venous hypertension. 38 The syndrome was especially recognized and identified in the case studies published in the recent 10 years (2010-2021). In this group, 75% (18/24) were reported to have concomitant iliac vein compression.…”

Section: Discussionmentioning

confidence: 99%

Successful Management of Spontaneous Iliac Vein Rupture with Double Bare Stent Technique: A Case Report and Review of Literature

Kwan

2022

Vasc Endovascular Surg

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Spontaneous rupture of the iliac vein is a rare cause of retroperitoneal hematoma. A misdiagnosis may delay the treatment and consequently put the patient in a life-threatening emergency. We report the case of a 73-year-old woman who presented with hemorrhagic shock from bleeding caused by a large left retroperitoneal hematoma. She was successfully treated with an endovascular approach by using a double bare stent technique. An extensive review of the literature was conducted and a total 44 articles with 50 patients were identified. Among these patients, 88.2% were women, 94.1% presented with a left-sided rupture, and the mortality rate was 13.7%. Spontaneous iliac vein rupture was more likely to occur in the left side in female patients. Conservative treatment was an option in hemodynamically stable patients. Exploratory laparotomy and surgical iliac vein repair was necessitated in most patients. Endovascular treatment including placement of covered stent and coil embolization had been widely used to treat spontaneous vein rupture since 2003. Double bare stent technique was also an effective alternative if a suitable covered stent was unavailable.

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“…We found a total of 53 cases mostly consisting of isolated case reports with Google search. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] . Jiang et al reported a series of 9 J o u r n a l P r e -p r o o f cases although in 4 of these patients, there were no imaging studies or operative findings to confirm iliac vein rupture .…”

Section: Discussionmentioning

confidence: 99%

“…We found a total of 53 cases, which were mostly from isolated case reports, using a Google search. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 Jiang et al 5 reported a series of nine patients, although for four of these patients, no imaging studies or operative findings to confirm iliac vein rupture were reported. Of these 53 cases, 14 patients died, for a mortality rate of 26.4%.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous iliac vein rupture: An uncommon, but frequently lethal, event

McCready

Kiell

Webb

2021

Journal of Vascular Surgery Cases, Innovations and Techniques

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Spontaneous Iliac Vein Rupture Due to May-Thurner Syndrome and Its Staged Management

Cited by 7 publications

References 8 publications

Diagnostic Value of the Iliac Vein Stenosis Percentage Combined With Indicators of Venous Reflux for Iliac Vein Compression Syndrome With Computed Tomography Venography

Diagnostic Value of the Iliac Vein Stenosis Percentage Combined With Indicators of Venous Reflux for Iliac Vein Compression Syndrome With Computed Tomography Venography

Successful Management of Spontaneous Iliac Vein Rupture with Double Bare Stent Technique: A Case Report and Review of Literature

Spontaneous iliac vein rupture: An uncommon, but frequently lethal, event

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