[MO-46] A Case of Iliac Vein Compression Syndrome after aortic replacement with a Y-shaped vascular prosthesis for Aortic Abdominal Aneurysm
Iliac vein compression syndrome (IVCS) due to abdominal aortic aneurysm (AAA) were reported. However, IVCS after aortic replacement for AAA wasn’t reported. Here we report a case of stenting at left common iliac vein due to IVCS after aortic replacement with a Y-shaped vascular prosthesis for AAA. An 80-year-old female was performed aortic replacement with a Y-shaped vascular prosthesis for AAA 5 years ago. She had the symptoms of left lower limb pain, leg fatigue and heaviness after aortic replacement. CT revealed the rapping aneurysm sac compressed left common iliac vein (LCIV) at the height of L5 spine. Venous ultrasound examination revealed LCIV was compressed between echo free space suspected the aneurysm sac and the L5 spine. Venography showed stenosis at the point where the aneurysm sac and multiple left-to-right pelvic collaterals. We planned venous stenting at LCIV for symptomatic IVCS. We chose to perform endovascular intervention but not bypass surgery, because her surgical risk was high due to past open abdominal surgery. In our patient, iliac vein stenting resulted in symptom resolution. AAA are treated with surgical aortic replacement or endovascular aneurysm repair (EVAR) to reduce the risk of rupture and to improve any associated symptoms or complications due to compression to intestine, ureter and iliac vein by aneurysm. Compression symptoms by AAA itself was reported previously, but it is first report that IVCS happened after aortic replacement with a Y-shaped vascular prosthesis post 5 years. We present that the patient underwent vein stenting for IVCS due to liquid pooling in the native aortic wall sac.