Review of imaging and endovascular intervention of iliocaval venous compression syndrome  

作　　者：Ming Ren Toh Tjun Yip Tang Han Hui Mervin Nathan Lim Nanda Venkatanarasimha Karthikeyan Damodharan 

机构地区：[1]Duke-NUS Medical School,Singapore 544886,Singapore [2]Department of Vascular surgery,Singapore General Hospital,Singapore 169608,Singapore [3]Yong Yoo Ling School of Medicine,Singapore 117597,Singapore [4]Department of Radiology,Singapore General Hospital,Singapore 169608,Singapore [5]Department of Radiology,SengKang General Hospital,Singapore 544886,Singapore

出　　处：《World Journal of Radiology》2020年第3期18-28,共11页世界放射学杂志（英文版）（电子版）

摘　　要：Iliocaval venous compression syndrome(ICS)is the extrinsic compression of the common iliac vein by the overlying iliac artery against the vertebra.Chronic compression can lead to venous stenosis and stasis,which manifests as chronic venous disease and treatment resistance.Therefore,early recognition of ICS and prompt treatment are essential.Clinical presentations of ICS can be ambiguous and diagnosis requires a high index of suspicion with the relevant imaging studies.The initial imaging test is typically a Duplex ultrasound for vessel assessment and pelvic ultrasound to exclude a compressive mass,which is followed by computed tomography(CT)or magnetic resonance(MR)venography.CT and MRI can identify the anatomical causes for venous compression.In patients with high clinical suspicion for ICS,negative findings on CT and MR venography would still warrant further investigations.Definitive diagnosis can be established using catheter-based venography complemented with intravascular ultrasonography but the nature of their invasiveness limits its utility as a routine imaging modality.In this review paper,we will discuss the evidence,utility and limitations of the existing imaging modalities and endovascular intervention used in the management of ICS.Iliocaval venous compression syndrome(ICS) is the extrinsic compression of the common iliac vein by the overlying iliac artery against the vertebra. Chronic compression can lead to venous stenosis and stasis, which manifests as chronic venous disease and treatment resistance. Therefore, early recognition of ICS and prompt treatment are essential. Clinical presentations of ICS can be ambiguous and diagnosis requires a high index of suspicion with the relevant imaging studies. The initial imaging test is typically a Duplex ultrasound for vessel assessment and pelvic ultrasound to exclude a compressive mass, which is followed by computed tomography(CT) or magnetic resonance(MR)venography. CT and MRI can identify the anatomical causes for venous compression. In patients with high clinical suspicion for ICS, negative findings on CT and MR venography would still warrant further investigations. Definitive diagnosis can be established using catheter-based venography complemented with intravascular ultrasonography but the nature of their invasiveness limits its utility as a routine imaging modality. In this review paper, we will discuss the evidence, utility and limitations of the existing imaging modalities and endovascular intervention used in the management of ICS.

关 键 词：Iliocaval venous compression syndrome Duplex ultrasound Intravascular ultrasound Computed tomography venography Magnetic resonance venography Endovascular stent 

分 类 号：R543[医药卫生—心血管疾病] R445.2[医药卫生—内科学]