Thrombosis of bilateral iliocaval stents
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Patient with bilateral iliocaval stent presents with diffuse bilateral lower extremity pain and engorged abdominal wall veins on physical exam.
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Complete occlusion of bilateral iliocaval stents. Extensive venous collaterals of the abdominal wall and retroperitoneum. Left scrotal varicocele.
Complete occlusion of the bilateral iliocaval stents secondary to thrombosis, with impressive abdominal wall and retroperitoneal venous collateral vessels. This patient had stents placed after being diagnosed with post thrombotic syndrome. After stent placement, the patient was non compliant with their anticoagulant regimen and subsequently developed thromboses of their stents.
Although the ultimate cause of this patient’s post thrombotic syndrome was never confirmed, compression of the left common iliac vein was found during intravenous ultrasound interrogation prior to stent placement. This finding is seen in May-Thurner syndrome, where the left common iliac vein is compressed by the right common iliac artery which can lead to deep venous thrombosis of the left common iliac vein.