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Semin intervent Radiol 2018; 35(04): 333-341
DOI: 10.1055/s-0038-1669963
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Endovascular Therapy for Lower Extremity Chronic Deep Venous Occlusive Disease: State of Practice

Vibhor Wadhwa
1   Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
,
Ravi N. Srinivasa
2   Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
,
Kyle J. Cooper
2   Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
3   Department of Radiology, Loma Linda University, Loma Linda, California
,
Anthony N. Hage
2   Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
,
Jacob J. Bundy
2   Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
,
Brooke Spencer
4   Minimally Invasive Procedure Specialists, Interventional Institute of Colorado, Parker, Colorado
,
Venu Vadlamudi
5   Cardiovascular and Interventional Radiology, Inova Alexandria Hospital, Alexandria, Virginia
,
Jeffrey Forris Beecham Chick
2   Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan
5   Cardiovascular and Interventional Radiology, Inova Alexandria Hospital, Alexandria, Virginia
› Author Affiliations
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Publication History

Publication Date:
05 November 2018 (online)

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Chronic deep venous thrombosis (DVT) of the inferior vena cava and the iliac veins, also known as chronic iliocaval thrombosis, is a cause of significant morbidity. This may lead to limb-threatening occlusive symptoms secondary to DVT in the lower extremities, phlegmasia cerulea dolens, and postthrombotic syndrome (PTS), and may be fatal secondary to development of pulmonary embolism.[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] PTS commonly presents with leg pain, swelling, venous claudication, cutaneous hyperpigmentation, varicose veins, and venous ulcers secondary to stasis. Iliocaval recanalization and reconstruction is a minimally invasive endovascular technique used in the management of chronic iliocaval thrombosis, which involves recanalization, angioplasty, and possibly stenting, with the ultimate aim of restoring in-line venous flow throughout the iliocaval system. This technique has been shown to provide significant symptomatic relief to patients while also potentially preventing recurrent thromboembolic disease.