Diagnosis of acute and chronic iliac vein thrombosis

Abstract

The clinical picture of acute iliac vein thrombosis can be dramatic. Iliac vein thrombosis is associated with a high risk of a life-threatening pulmonary embolism. It can also result in the development of phlegmasia cerulea dolens, a dangerous complication which can lead to the loss of the affected extremity. In addition to conservative treatment approaches, such as compression therapy and anticoagulation, there are a number of interventions that can limit the severity of post-thrombotic syndrome and prevent the disease from becoming fatal.

The prognosis of the disease depends to a large extent on an early and reliable diagnosis. Duplex ultrasound plays a key role both in the acute and chronic stages of the disease. It sheds light on the pathomorphology of the iliac and leg veins and provides information about the dynamics of blood flow.

In contrast to an ultrasound examination of the deep and epifascial veins in the leg, investigating the proximal vascular segments requires the use of both a linear and curved-array probe. A limited resolution deep inside the pelvis requires delicate handling of the settings on the ultrasound device.

Radiological and functional diagnostic methods can provide additional information for treating post-thrombotic changes in the iliac veins.

Key words

Duplex ultrasound - iliac veins - iliac vein stenting - iliac vein recanalization - May-Thurner syndrome

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