Right-sided Cockett’s syndrome

Abstract

Background Cockett and Thomas described and named Cockett's syndrome in 1965, commonly referred to as iliac vein compression syndrome (IVCS). It is often found as underlying cause in iliofemoral deep venous thrombosis (DVT). They described the syndrome mostly seen on the left side and predominantly in women during the second to the fourth decade of life. In this article, we present a patient with a Cockett's syndrome on the right side. Case presentation Our patient is a 52-year old female with edema of the right leg since 4 months. She had no signs of a DVT and did not benefit from a 3-month compression therapy. She was diagnosed using a CT-scan. Endovascular treatment was performed with a venous stent in the right common iliac vein (CIV). No postoperative complications were seen. After a 6-month follow-up, patient was free of pain and had no residual edema of the right leg. Conclusions Our patient presented with a non-complicated right-sided Cockett's syndrome. She was successfully treated with balloon dilatation and additional stenting of the right common iliac vein. Because of the clinical improvement of the patient together with the excellent long-term results and good patency results of the stenting, guidelines nowadays advise more and more venous stenting to prevent DVT and to relieve symptoms in case of vein compression syndromes.

Identificação pela ultrassonografia vascular da compressão da veia ilíaca comum esquerda em mulheres assintomáticas: ortostatismo pode influenciar o diagnóstico?

“… 15 These anatomic variations in where the artery crosses over the common iliac veins mean it is even possible for there to be compression of the right common iliac vein. 16 …”

“…Na maioria das vezes (75%), a AICD cruza com a VICE na topografia da junção com a veia ilíaca comum direita; em 15% dos casos, um pouco acima da junção das veias ilíacas comuns; e, em 10%, abaixo da junção venosa 15 . Essas variantes anatômicas de cruzamento arterial sobre as veias ilíacas comuns permitem a possibilidade de compressão inclusive na veia ilíaca comum direita 16 .…”

Endovascular Deep Vein Stenting of Symptomatic Post-Thrombotic and Non-Thrombotic Iliac Vein Stenotic Lesions: A Multicentre Cohort Experience from Singapore

“…2 Right sided and bilateral MTS have also been reported, albeit rare. [3][4][5] PTS develops in up to half of patients with deep vein thrombosis (DVT), causing intraluminal scarring and venous obstruction. 6 Previously, IFVO was treated with analgesia, compression stockings and anticoagulation.…”