Zilver stent implantation through 4.5 French guiding sheath in iliac vein compression syndrome complicated with acute deep vein thrombosis

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• 作者：Sho Hashimoto ; MD^a ; Jun Shiraishi ; MD ; FJCC^a ; ^{risa11221998@yahoo.co.jp} ; Masayoshi Kimura ; MD^a ; Daisuke Ito ; MD^a ; Akihiro Matsui ; MD^a ; Hirokazu Yokoi ; MD^a ; Masayasu Arihara ; MD^b ; Hidekazu Irie ; MD^a ; Masayuki Hyogo ; MD^a ; Takatomo Shima ; MD^a ; Yoshio Kohno ; MD^a
• 关键词：Iliac vein compression syndrome ; Deep vein thrombosis ; Zilver stent ; Intravascular ultrasound imaging ; Thrombectomy
• 刊名：Journal of Cardiology Cases
• 出版年：2013
• 出版时间：February, 2013
• 年：2013
• 卷：7
• 期：2
• 页码：e53-e56
• 全文大小：801 K

文摘

Background

Downsized devices for less invasive endovascular treatment are gaining more attention.

Case report

An 82-year-old woman was admitted to our hospital with pain and swelling in left lower extremity. Ultrasonography showed much thrombus at the left common femoral, superficial femoral, and popliteal veins, confirming a diagnosis of acute deep vein thrombosis (DVT). For lack of therapeutic effect of systemically administered anticoagulative and thrombolytic agents, we performed catheter intervention against DVT. After insertion of a 4.5 French guiding sheath (Parent Plus, Medikit, Tokyo, Japan) into left popliteal vein, venography showed a total occlusion of the common femoral vein. Even after thrombectomy by aspiration catheter, balloon dilation, and catheter-induced thrombolysis, severe stenosis at the proximal site of the left common iliac vein remained. After confirming the presence of iliac vein compression syndrome (IVCS) by intravascular ultrasound imaging, we successfully implanted a Zilver^? stent (Cook Inc., Bloomington, IN, USA) in the common-external iliac vein through a 4.5 French guiding sheath, leading to an optimal venous-return flow.

Conclusions

The present case suggests that in addition to thrombus aspiration, Zilver stent implantation using a 4.5 French guiding sheath has the potential to serve as a minimally invasive strategy for the treatment of IVCS complicated with iliofemoral DVT.

<Learning objective: During the interventional treatment of deep vein thrombosis, we should pay attention to procedure-related venous valve dysfunction in addition to bleeding complications and pulmonary embolism. From the point of view, downsized catheter devices might have some advantage with lesser prevalence of those complications.>