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Lawrence V. Hofmann - One of the best experts on this subject based on the ideXlab platform.
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Correlation of the Diameter of the Left Common Iliac Vein with the Risk of Lower-extremity Deep Venous Thrombosis
Journal of Vascular and Interventional Radiology, 2012Co-Authors: Stephanie A. Carr, William T. Kuo, Nishita Kothary, Daniel Y. Sze, David M Hovsepian, Keith Syson Chan, Jarrett Rosenberg, Lawrence V. HofmannAbstract:Abstract Purpose Compression of the left Common Iliac Vein (CIV; LCIV) is a known risk factor for lower-extremity deep Vein thrombosis (DVT). This study was performed to model the probability of DVT based on LCIV diameter and apply this to a quantitative DVT risk factor scoring system. Materials and Methods Medical records were used to identify female patients younger than 45 years of age who were diagnosed with lower-extremity DVT (n = 21) and age-matched control subjects (n = 26) who presented to the emergency department with abdominal pain. Minimum CIV diameters were measured on computed tomography. Based on published reporting standards, 13 risk factors were scored for patients diagnosed with left-sided DVT and for control subjects. The association between Vein diameter and DVT was examined by Mann–Whitney test. Odds of DVT based on Vein diameter was assessed by logistic regression. Results Mean minimum LCIV diameters were 4.0 mm for patients with DVT and 6.5 mm for patients without DVT ( P = .001). The odds of left DVT increased by a factor of 1.68 for each millimeter decrease in LCIV diameter (odds ratio=1.68; P = .006; 95% confidence interval, 1.16–2.43). As the risk factor score increased, the relationship between diameter and risk for DVT became stronger; identical LCIV diameters were associated wtih a higher probability of developing DVT if the risk factor score was higher. Conclusions Stenosis of the LCIV was found to be a strong independent risk factor for development of DVT. Moreover, each millimeter decrease in CIV diameter increased the odds of DVT by a factor of 1.68.
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Common Iliac Vein stenosis and risk of symptomatic pulmonary embolism an inverse correlation
Journal of Vascular and Interventional Radiology, 2011Co-Authors: Keith T. Chan, Rita A. Popat, William T. Kuo, Nishita Kothary, Daniel Y. Sze, John D Louie, David M Hovsepian, Gloria L Hwang, Lawrence V. HofmannAbstract:Abstract Purpose To test the hypothesis that a Common Iliac Vein (CIV) stenosis may impair embolization of a large deep venous thrombosis (DVT) to the lungs, decreasing the incidence of a symptomatic pulmonary embolism (PE). Materials and Methods Between January 2002 and August 2007, 75 patients diagnosed with unilateral DVT were included in a single-institution case-control study. Minimum CIV diameters were measured 1 cm below the inferior vena cava (IVC) bifurcation on computed tomography (CT) images. A significant stenosis in the CIV ipsilateral to the DVT was defined as having either a diameter 4 mm or less or a greater than 70% reduction in lumen diameter. A symptomatic PE was defined as having symptoms and imaging findings consistent with a PE. The odds of symptomatic PE versus CIV stenosis were assessed using logistic regression models. The associations between thrombus location, stenosis, and symptomatic PE were assessed using a stratified analysis. Results Of 75 subjects, 49 (65%) presented with symptomatic PE. There were 17 (23%) subjects with a venous lumen 4 mm or less and 12 (16%) subjects with a greater than 70% stenosis. CIV stenosis of 4 mm or less resulted in a decreased odds of a symptomatic PE compared with a lumen greater than 4 mm (odds ratio [OR] 0.17, P = .011), whereas a greater than 70% stenosis increased the odds of DVT involving the CIV (OR 7.1, P = .047). Conclusions Among patients with unilateral DVT, those with an ipsilateral CIV lumen of 4 mm or less have an 83% lower risk of developing symptomatic PE compared with patients with a CIV lumen greater than 4 mm.
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Common Iliac Vein stenosis: A risk factor for oral contraceptive-induced deep Vein thrombosis
American Journal of Obstetrics and Gynecology, 2011Co-Authors: Keith T. Chan, Grace A. Tye, Rita A. Popat, William T. Kuo, Kamil Unver, Nishita Kothary, Daniel Y. Sze, Lawrence V. HofmannAbstract:Objective The objective of the study was to determine whether women with significant left Common Iliac Vein stenosis who also use combined oral contraceptives (COCs) have a combined likelihood of deep Vein thrombosis (DVT) greater than each independent risk. Study Design This was a case-control study comparing 35 women with DVT against 35 age-matched controls. Common Iliac Vein diameters were measured from computed tomography and magnetic resonance imaging. Logistic regression modeling was used with adjustment for risk factors. Results DVT was associated with COC use ( P = .022) and with increasing degrees of Common Iliac Vein stenosis ( P = .004). Compared with women without venous stenosis or COC use, the odds of DVT in women with a 70% venous stenosis who also use COCs was associated with a 17-fold increase ( P = .01). Conclusion Venous stenosis and COC use are independent risk factors for DVT. Women concurrently exposed to both have a multiplicative effect resulting in an increased risk of DVT. We recommend further studies to investigate this effect and its potential clinical implications.
Hyung Tae Kim - One of the best experts on this subject based on the ideXlab platform.
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spontaneous rupture of the left Common Iliac Vein associated with may thurner syndrome successful management with surgery and placement of an endovascular stent
British Journal of Radiology, 2007Co-Authors: Young Hwan Kim, Hyung Tae KimAbstract:We report a case of spontaneous rupture of the left Common Iliac Vein diagnosed pre-operatively with CT and successfully treated with surgery and placement of a stent. A 60-year-old woman was referred to our emergency room because of a sudden left lower abdominal pain and swelling of the left lower extremity. CT revealed a huge retroperitoneal haematoma and extrinsic compression of the left Common Iliac Vein with acute thrombosis of deep Veins of the left lower extremity. Venous patch angioplasty was performed at the site of spontaneous rupture. After thrombectomy with use of a Forgaty catheter, a stent was placed at the occluded segment of the left Common Iliac Vein under the C-arm fluroscopic guidance. Follow-up CT 10 days and 8 months after initial examination demonstrated a venous stent with preserved luminal patency and striking resolution of deep Vein thrombosis of the left lower extremity.
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Spontaneous rupture of the left Common Iliac Vein associated with May–Thurner syndrome: successful management with surgery and placement of an endovascular stent
The British Journal of Radiology, 2007Co-Authors: Young Hwan Kim, Hyung Tae KimAbstract:We report a case of spontaneous rupture of the left Common Iliac Vein diagnosed pre-operatively with CT and successfully treated with surgery and placement of a stent. A 60-year-old woman was referred to our emergency room because of a sudden left lower abdominal pain and swelling of the left lower extremity. CT revealed a huge retroperitoneal haematoma and extrinsic compression of the left Common Iliac Vein with acute thrombosis of deep Veins of the left lower extremity. Venous patch angioplasty was performed at the site of spontaneous rupture. After thrombectomy with use of a Forgaty catheter, a stent was placed at the occluded segment of the left Common Iliac Vein under the C-arm fluroscopic guidance. Follow-up CT 10 days and 8 months after initial examination demonstrated a venous stent with preserved luminal patency and striking resolution of deep Vein thrombosis of the left lower extremity.
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Spontaneous Rupture of the Left Common Iliac Vein: Management with Surgical Repair and Endovascular Stent
Journal of the Korean Radiological Society, 2006Co-Authors: Young Hwan Kim, Sang Kwon Lee, Jin Soo Choi, Ja Hyun Koo, Hyung Tae Kim, Wonhyun ChoAbstract:We report here on a case of spontaneous rupture of the left Common Iliac Vein that was diagnosed preoperatively with computed tomography (CT), and the patient was successfully treated with surgery and stent placement. A 60-year-old woman was referred to our emergency room because of sudden left lower abdominal pain and swelling of the left lower extremity. CT revealed a huge retroperitoneal hematoma and extrinsic compression of the left Common Iliac Vein with acute thrombosis of the deep Veins of the left lower extremity. Venous patch angioplasty was performed at the site of spontaneous rupture. After performing thrombectomy with using a Forgaty catheter, a stent was placed at the occluded segment of the left Common Iliac Vein under C-arm fluoroscopic guidance. The follow-up CT scans taken at 10 days and 8 months after the initial examination demonstrated a venous stent with preserved luminal patency and the striking resolution of the deep Vein thrombosis of the left lower extremity.
Iris Baumgartner - One of the best experts on this subject based on the ideXlab platform.
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patency and clinical outcomes of a dedicated self expanding hybrid oblique stent used in the treatment of Common Iliac Vein compression
Journal of Endovascular Therapy, 2017Co-Authors: Anna K. Stuck, Iris Baumgartner, Samuel Kunz, Nils KucherAbstract:Purpose: To investigate the clinical outcomes of a dedicated hybrid oblique nitinol stent that has been specifically designed to treat Common Iliac Vein compression. Methods: The Bern Venous Stent Registry database was interrogated to identify all patients who had at least 6-month follow-up after treatment with the sinus-Obliquus hybrid stent for Common Iliac Vein compression. The search identified 24 patients (mean age 39±18 years; 20 women) who matched the search criteria. Ten patients had postthrombotic syndrome (PTS), another 10 patients had acute iliofemoral thrombosis after catheter-directed therapy, and 4 patients had nonthrombotic Iliac Vein compression. Primary treatment success was defined as antegrade flow and stenosis <30% on venography and evidence of a spontaneous Doppler signal in the treated segment. Stent patency was assessed using duplex ultrasound. Clinical outcomes were evaluated using a clinical symptom score (Villalta) and the revised venous clinical severity score (rVCSS) at 3, 6, a...
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Patency and Clinical Outcomes of a Dedicated, Self-Expanding, Hybrid Oblique Stent Used in the Treatment of Common Iliac Vein Compression.
Journal of Endovascular Therapy, 2016Co-Authors: Anna K. Stuck, Iris Baumgartner, Samuel Kunz, Nils KucherAbstract:Purpose: To investigate the clinical outcomes of a dedicated hybrid oblique nitinol stent that has been specifically designed to treat Common Iliac Vein compression. Methods: The Bern Venous Stent Registry database was interrogated to identify all patients who had at least 6-month follow-up after treatment with the sinus-Obliquus hybrid stent for Common Iliac Vein compression. The search identified 24 patients (mean age 39±18 years; 20 women) who matched the search criteria. Ten patients had postthrombotic syndrome (PTS), another 10 patients had acute iliofemoral thrombosis after catheter-directed therapy, and 4 patients had nonthrombotic Iliac Vein compression. Primary treatment success was defined as antegrade flow and stenosis
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Stenting of Common Iliac Vein obstructions combined with regional thrombolysis and thrombectomy in acute deep Vein thrombosis
European Journal of Vascular and Endovascular Surgery, 2007Co-Authors: Marc Husmann, G. Heller, Christoph Kalka, Hannu Savolainen, D. D., Jürg Schmidli, Iris BaumgartnerAbstract:OBJECTIVES: To evaluate the efficacy of stent placement after infrainguinal loco-regional thrombolysis and Iliac thrombectomy (surgical TT) of acute deep Vein thrombosis (DVT) in patients with May-Thurner-Syndrome. MATERIAL AND METHODS: We retrospectively analysed a group of 11 patients (9 women) (mean age 34 years, range 16-64 years) with surgical TT and additional intra-operative stenting due to compression of the Common Iliac Vein. Patients underwent venography to demonstrate outflow patency after surgical TT, and to identify any obstruction at the level of the left-sided Common Iliac Vein ("Beckenvenen-Sporn"). Obstruction at the level of arterial crossing was treated using Wallstents placed via an introducer sheath from the inguinal access site. Stents were fully deployed using balloons adjusted to the size of Vein. Patients were treated with oral anticoagulants for 6 months, and followed using duplex ultrasonography. RESULTS: Technical success defined as complete Vein patency and normal valve function was documented in all 11 patients. One patient needed early stent extension due to residual stenosis. At 6 months follow-up one patient (9%) had an asymptomatic occlusion of the stented Common Iliac Vein. In all 11/11 (100%) patients the femoral segment was found to be patent, and in 1/11 (9%) there was mild reflux with few clinical symptoms of post-thrombotic syndrome. The calculated cumulative primary patency rate for venous Iliac stents was 82%, and assisted patency rate was 91%, which remained unchanged over a mean follow-up of 22 months. CONCLUSION: Combining surgical TT and stenting of Common Iliac Vein obstructions in DVT is safe, effective, and results in a acceptable venous patency.
Nils Kucher - One of the best experts on this subject based on the ideXlab platform.
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patency and clinical outcomes of a dedicated self expanding hybrid oblique stent used in the treatment of Common Iliac Vein compression
Journal of Endovascular Therapy, 2017Co-Authors: Anna K. Stuck, Iris Baumgartner, Samuel Kunz, Nils KucherAbstract:Purpose: To investigate the clinical outcomes of a dedicated hybrid oblique nitinol stent that has been specifically designed to treat Common Iliac Vein compression. Methods: The Bern Venous Stent Registry database was interrogated to identify all patients who had at least 6-month follow-up after treatment with the sinus-Obliquus hybrid stent for Common Iliac Vein compression. The search identified 24 patients (mean age 39±18 years; 20 women) who matched the search criteria. Ten patients had postthrombotic syndrome (PTS), another 10 patients had acute iliofemoral thrombosis after catheter-directed therapy, and 4 patients had nonthrombotic Iliac Vein compression. Primary treatment success was defined as antegrade flow and stenosis <30% on venography and evidence of a spontaneous Doppler signal in the treated segment. Stent patency was assessed using duplex ultrasound. Clinical outcomes were evaluated using a clinical symptom score (Villalta) and the revised venous clinical severity score (rVCSS) at 3, 6, a...
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Patency and Clinical Outcomes of a Dedicated, Self-Expanding, Hybrid Oblique Stent Used in the Treatment of Common Iliac Vein Compression.
Journal of Endovascular Therapy, 2016Co-Authors: Anna K. Stuck, Iris Baumgartner, Samuel Kunz, Nils KucherAbstract:Purpose: To investigate the clinical outcomes of a dedicated hybrid oblique nitinol stent that has been specifically designed to treat Common Iliac Vein compression. Methods: The Bern Venous Stent Registry database was interrogated to identify all patients who had at least 6-month follow-up after treatment with the sinus-Obliquus hybrid stent for Common Iliac Vein compression. The search identified 24 patients (mean age 39±18 years; 20 women) who matched the search criteria. Ten patients had postthrombotic syndrome (PTS), another 10 patients had acute iliofemoral thrombosis after catheter-directed therapy, and 4 patients had nonthrombotic Iliac Vein compression. Primary treatment success was defined as antegrade flow and stenosis
Young Hwan Kim - One of the best experts on this subject based on the ideXlab platform.
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spontaneous rupture of the left Common Iliac Vein associated with may thurner syndrome successful management with surgery and placement of an endovascular stent
British Journal of Radiology, 2007Co-Authors: Young Hwan Kim, Hyung Tae KimAbstract:We report a case of spontaneous rupture of the left Common Iliac Vein diagnosed pre-operatively with CT and successfully treated with surgery and placement of a stent. A 60-year-old woman was referred to our emergency room because of a sudden left lower abdominal pain and swelling of the left lower extremity. CT revealed a huge retroperitoneal haematoma and extrinsic compression of the left Common Iliac Vein with acute thrombosis of deep Veins of the left lower extremity. Venous patch angioplasty was performed at the site of spontaneous rupture. After thrombectomy with use of a Forgaty catheter, a stent was placed at the occluded segment of the left Common Iliac Vein under the C-arm fluroscopic guidance. Follow-up CT 10 days and 8 months after initial examination demonstrated a venous stent with preserved luminal patency and striking resolution of deep Vein thrombosis of the left lower extremity.
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Spontaneous rupture of the left Common Iliac Vein associated with May–Thurner syndrome: successful management with surgery and placement of an endovascular stent
The British Journal of Radiology, 2007Co-Authors: Young Hwan Kim, Hyung Tae KimAbstract:We report a case of spontaneous rupture of the left Common Iliac Vein diagnosed pre-operatively with CT and successfully treated with surgery and placement of a stent. A 60-year-old woman was referred to our emergency room because of a sudden left lower abdominal pain and swelling of the left lower extremity. CT revealed a huge retroperitoneal haematoma and extrinsic compression of the left Common Iliac Vein with acute thrombosis of deep Veins of the left lower extremity. Venous patch angioplasty was performed at the site of spontaneous rupture. After thrombectomy with use of a Forgaty catheter, a stent was placed at the occluded segment of the left Common Iliac Vein under the C-arm fluroscopic guidance. Follow-up CT 10 days and 8 months after initial examination demonstrated a venous stent with preserved luminal patency and striking resolution of deep Vein thrombosis of the left lower extremity.
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Spontaneous Rupture of the Left Common Iliac Vein: Management with Surgical Repair and Endovascular Stent
Journal of the Korean Radiological Society, 2006Co-Authors: Young Hwan Kim, Sang Kwon Lee, Jin Soo Choi, Ja Hyun Koo, Hyung Tae Kim, Wonhyun ChoAbstract:We report here on a case of spontaneous rupture of the left Common Iliac Vein that was diagnosed preoperatively with computed tomography (CT), and the patient was successfully treated with surgery and stent placement. A 60-year-old woman was referred to our emergency room because of sudden left lower abdominal pain and swelling of the left lower extremity. CT revealed a huge retroperitoneal hematoma and extrinsic compression of the left Common Iliac Vein with acute thrombosis of the deep Veins of the left lower extremity. Venous patch angioplasty was performed at the site of spontaneous rupture. After performing thrombectomy with using a Forgaty catheter, a stent was placed at the occluded segment of the left Common Iliac Vein under C-arm fluoroscopic guidance. The follow-up CT scans taken at 10 days and 8 months after the initial examination demonstrated a venous stent with preserved luminal patency and the striking resolution of the deep Vein thrombosis of the left lower extremity.