What Is Iliocaval IVUS and Stenting?

 

When patients have pain, heaviness, cramps and weakness in their legs, clinical findings on physical exam suggestive of vein disease, and venous reflux in the common femoral vein on ultrasound, this is frequently due to compression of the Iliac and femoral vein from the Iliac artery, which crosses this vein. We are now able to effectively treat this condition, relieving the symptoms and the improving function.

 

The artery is a heavy thick-walled tube, like a garden hose. The vein is a thin flimsy tube, like saran wrap. The heavy artery can compress the thin vein when it crosses over it.

 

We use ultrasound to identify this compression. In the cath lab, we insert a sheath (a tube with a one way valve) into each femoral vein. Then we insert an ultrasound probe mounted on a catheter into the sheath.  This intra-vascular ultrasound (IVUS) shows the cross sectional shape of the vein, and we can measure what percentage it is compressed.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If we find compression of more than 50% on IVUS measurement, we scaffold the vein open with a large stent. This stent allows the vein to remain open, and blood can flow back to the heart more easily, which relieves the “traffic jam” of blood backing up in the vein that compression created.

 

By allowing blood to LEAVE the leg more easily, it allows blood to ENTER the leg more easily, improving arterial flow to the leg. This can improve exercise ability, improve sensation of the skin, allow wounds to heal better, and relieve symptoms like leg cramps, heaviness, restless legs, swelling  and leg pain.

 

This technique has been performed for over 15 years, and is well described in the medical literature.

Dr. Saxena has performed more of these procedures than any other doctor in the state of Alabama. Call for more information, or to schedule an appointment with our board certified cardiovascular specialist.

Uncompressed vein on IVUS

Compressed vein on IVUS

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