Venous stenting using intravascular ultrasound

Abstract

Venoplasty and stenting of the iliac vein now constitute the 'method of choice' in the treatment of iliocaval chronic venous obstruction.1-8 The importance of venous outflow obstruction in the pathophysiology of chronic venous disorders has been increasingly recognized, and it is apparent that reflux alone cannot explain the symptoms and signs in many patients. Although it is well known that the combination of reflux and obstruction creates the worst scenario, iliofemoral outflow obstruction alone may play a larger role in the pathophysiology of chronic venous disorders than previously thought. The iliac vein is the common outflow tract of the lower extremity and chronic obstruction of this segment appears to result in more severe symptoms than does lower segmental blockage. Distal obstructions appear to be better compensated by collateral formation than proximal lesions. Therefore, the iliocaval venous segment has become the most important target area for balloon dilation and stenting. © 2007 Springer-Verlag London Limited.