65 year old male, T3a prostate cancer. Underwent robotic lymph node dissection for staging. Post operative lymphocele developed along the left external iliac vein. Percutaneous drainage decompressed the fluid collect and improved the leg swelling. Collection re-occurred and the leg swelling worsened with severe pain. Venography and intravascular ultrasound (IVUS) showed severe narrowing of the external iliac vein. Stenting and venoplasty of the external iliac vein was performed with complete resolution of the leg swelling and pain.
79 year old female with non healing ulcers. Occlusion of all three arteries in the calf.
Endovascular therapy of external iliac and common femoral artery occlusion with 31 month follow up
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.