Authors: Tae An Choi ANP-BC & Back Kim MD FACC.
Heart Vein NYC, New York, New York
Case 1: 37-year-old diabetic female presenting with left leg swelling and pain with burning feet, worse upon standing, especially working as a home attendance.
A. Transabdominal iliac venous Doppler demonstrating the pathologic narrowing of left proximal common iliac vein (CIV) compressed by right common iliac artery (CIA)
B. Digital Subtraction Angiography (DSA) with contrast injection showing near-occlusion of left CIV. Noted left-to-right cross-pelvic collateral veins, transversing into right CIV.
C. Intravascular ultrasound (IVUS) demonstrating approximately 75% luminal narrowing of left CIV compressed by right CIA.
Case 2. 65-year-old female with bilateral leg swelling, heaviness, skin discoloration (hyperpigmentation) and life-limiting venous claudication (left discomfort upon walking or exercising) with associated with left gluteal achiness and stiffness.
A. Iliac vein Doppler demonstrating the severe narrowing of left CIV compressed by right CIA. Noted post-stenotic turbulence flow as shown by mosaic pattern
B. Venogram with contrast injection showing near-occlusion of left CIV.
C. IVUS demonstrating approximately 80% luminal narrowing of left CIV compressed by right CIA.
More sonographic imagines of MTS:
