Extrinsic compression of the right external iliac artery secondary to iliac vein stenting

Abstract

Symptomatic extrinsic compression of the external iliac artery (EIA) is a rare complication of surgical intervention. Previous cases of EIA compression have presented in the postoperative period after orthopedic surgery or vascular stenting. We report a case of right EIA compression postvenous stenting causing acute limb ischemia.

Extrinsic arterial compression and lower extremity ischemia after iliac vein stent placement: case report, review of literature

“…This report highlights s case of arterial ischemia secondary to extrinsic compression from venous stents. This appears to be a rare but increasingly recognized complication, as there has been a cluster of case reports published within recent years (Filtes et al 2021;Trinidad et al 2022;Subramaniam et al 2021;Vasudev et al 2019;Taylor et al 2020).…”

“…One report describes the need for transfemoral amputation and subsequent issues with wound healing which required additional surgery (Trinidad et al 2022). Reported symptoms from this process are consistent with threatened limb, including pallor, pain, diminished pulses, and motorsensory loss (Filtes et al 2021;Subramaniam et al 2021;Taylor et al 2020).…”

“…If the situation is not emergent and the clinical picture is unclear, CT angiogram can be considered to rule out other potential causes of ischemia, such as hematoma or distal thromboembolism. Vascular surgery should also be engaged early if there is suspicion for compartment syndrome or the need for open revascularization (Filtes et al 2021;Subramaniam et al 2021;Vasudev et al 2019;Taylor et al 2020).…”

“…Although the risk factors for this phenomenon have not been rigorously studied, there are common themes within the published literature. Case reports have described this complication among patients with active pelvic malignancy, previously irradiated fields, prior pelvic surgeries, or other inflammatory processes (Filtes et al 2021;Trinidad et al 2022;Subramaniam et al 2021;Vasudev et al 2019;Taylor et al 2020). These factors likely result in decreased compliance of the perivascular soft tissues, ultimately transferring greater compressive forces on the artery by adjacent venous stents.…”

“…While there is no clear trend, use of certain stents may contribute to the occurrence of this complication. Case reports have described this complication in the presence of both covered and uncovered stents, as well as selfexpanding and balloon-expandable stents (Filtes et al 2021;Trinidad et al 2022;Subramaniam et al 2021;Vasudev et al 2019;Taylor et al 2020). The stent used in our procedure was a Viabahn VBX balloon-expandable covered stent graft (W. L. Gore & Associates Inc, Newark, DE, USA).…”