Advances in vein imaging technology (Intravascular Ultrasound – “IVUS”) have recently allowed vein specialists to diagnose a group of serious, but treatable, medical conditions which, until now, were greatly under-recognized.
The blood in our leg veins, returning to the heart, has to pass through large veins in the pelvis called iliac veins. While acute blood clots in the iliac veins are relatively routine to diagnose and treat, most iliac vein problems are due instead to either chronic vein scarring (from old DVT blood clots) or compression between the arteries and the spine (“May Thurner” Syndrome) which have been (until now) difficult to diagnose using standard tests such as ultrasound, CT scans, or even venograms (dye injection).
Vein specialists have long been at a loss on how to treat many patients who have the typical findings of severe vein disease (skin discoloration, swelling, leg ulcers, etc) but who have nothing wrong on the leg ultrasound or have persistent symptoms after successful treatment of the varicose veins or after prior DVT. This has left many suffering patients, and perplexed doctors, without a satisfactory solution to the problem.
Now things have changed. There is a technology called Intravascular Ultrasound (IVUS) which uses a very thin catheter with a tiny ultrasound probe at the tip which can be inserted into the veins directly. Under a local anesthetic and a small needle, the IVUS can be inserted into blood vessels and allows physicians to actually see the inside of veins and arteries with amazing precision. Over the last few years physicians have been using IVUS to look at the iliac veins and have discovered that many patients suffering from swelling, skin discoloration, and ulceration of the legs have previously unrecognized severe narrowing of the iliac veins as the cause. This can be caused either by compression between the artery and the spine, or by chronic scarring in the vein from old blood clots. Sometimes an iliac vein can be completely scarred shut by scarred, chronic clot (“DVT”).
The news gets even better. Not only does IVUS allow us to diagnose this problem easily and safely, but we can fix these narrowed iliac veins at the same time by immediately placing a stent in the vein – as just another part of the IVUS test. Stents have been used for decades to treat narrowed blood vessels. Stents are flexible metal mesh tubes which are inserted into the vein, pushed open with an angioplasty balloon, and remain in the vein holding it open. The vast majority of patients who get iliac vein stents see a remarkable improvement or resolution of their problem.
And even better, here at Advanced Vascular, we can provide our patients with IVUS and vein stenting in the comfort and convenience of our Morristown office. Our patients spend a few hours with us and then are sent home the same day with immediate return to normal activity.
If you think you might benefit from IVUS testing or iliac vein stenting, give us a call 1t 201-265-5300 for a consultation.