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J Korean Soc Emerg Med > Volume 14(4); 2003 > Article
Journal of The Korean Society of Emergency Medicine 2003;14(4): 371-377.
Deep Vein Thrombosis Caused by Iliac Vein Compression Syndrome in Emergency Department
Woo Jeong Kim, Sang Do Shin, Dong Hoon Kim, Young Ho Kwak, Joong Eui Rhee, Gil Joon Suh, Yeo Kyu Youn
1Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea. suhgil@snu.ac.kr
2Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Iliac vein compression syndrome (IVCS) is a clinical condition accompanied by deep vein thrombosis (DVT) secondary to the compression of the left common iliac vein between the right common iliac artery and the lumbar vertebrae. The purpose of this study was to find differences in the clinical characteristics between IVCS and other DVT and to analyze the therapeutic outcomes of IVCS.
A total of 140 patients with DVT visited the Emergency Department of Seoul National University Hospital from January 2000 to December 2002. Of those patients, 20 patients were diagnosed as IVCS (14.3%). The medical records of patients with both IVCS and DVT were retrospectively reviewed and compared.
All patients with IVCS presented with swelling confined to the left lower extremity. The IVCS group showed a higher incidence of females, more cardiovascular disease, and fewer malignancies than did the DVT group. There were no significant differences in age, other underlying diseases, abnormalities of coagulation, and the incidences of pulmonary embolism between two groups. Anticoagulation with heparin (100%), thrombolysis with urokinase (95%), balloon angioplasty (80%) and metallic stent insertion (75%) were performed for the treatment of IVCS. The prognosis fot the stent insertion group tended to be better, but the difference was not statistically significant.
We suggest that IVCS should be considered in patients who present with swelling confined to the left lower extremity, are females, and have a cardiovascular disease. A multicenter study seems to be needed for further evaluation of IVCS.
Key words: Deep vein thrombosis, Iliac vein compression syndrome
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