It results from extrinsic compression of left iliac vein
by an anomalous overlying right iliac artery which predisposes to deep venous thrombosis.
Before surgery, we discussed with the vascular surgeons how to deal with the left iliac vein
. In general, blood vessel reconstruction and subsequent anticoagulation therapy are performed.
However, pelvic and iliac vein
thrombosis can be missed with ultrasound because of overlying bowel gas .
A contrast-enhanced CT showed a narrowing of the right external iliac vein
without any thromboemboli in both lower extremities; however, she was incidentally found to have suspicious emboli in her pulmonary arteries.
compression syndrome (IVCS), also known as May–Thurner syndrome or Cockett syndrome, is characterized by left common iliac vein
(LCIV) compression by the right iliac artery (RIA) and the fifth lumbar vertebra.
This equates to an increase in iliac vein
outflow of approximately 550 mL/min in a 70 kg adult male.
The second zone lies between the sacral promontory medially and the internal iliac vein
In this case, we initially intended to treat the patient via surgical resection; however, we abandoned the total resection because the tumor was found to be ill-defined and adherent to the sacrum and common iliac vein
during the intraoperative examination.
Although the next day pelvic and abdominal CT angiography showed the extent of patient bleeding and of course patent iliac vein
stent (Figure 6), she passed an uneventful course in following days of admission.
"They ran some blood tests and an ultrasound and found a massive blood clot that went from the top of my thigh to my iliac vein
in my pelvis.
The tributaries of internal iliac vein
along with the main trunk were removed in toto, taking care not to injure the branches of IIA.