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FIGURE 60.9 A. (Left) Prestent intraoperative transfemoral venogram showing a nonthrombotic lesion proximally with translucency of the common iliac vein. An axial collateral or an intraluminal septa is suggested. (Right) IVUS of the same vein at different levels shows severe proximal common iliac vein (CIV) stenosis due to compression by the crossing iliac artery and normal distal CIV (top images). There is no compression of the external iliac vein at the bifurcation of the iliac artery (internal iliac (IIA) and external iliac (EIA) arteries) (middle) and normal width of the external iliac vein (bottom). The adjacent artery is marked with an A. The black circle within the vein is the IVUS catheter.

B. The IVUS investigation clearly delineated the extent of the lesion, which was limited to the proximal common iliac vein (CIV). (Left) The balloon venoplasty is performed with obvious wasting of the balloon at the site of the stenosis. Because of immediate recoil, a stent is placed well into the IVC and distally covering the CIV. (Right) The repeat venogram shows no translucency but still filling of the axial collateral.

angioplasty and stent placement to treat iliac venous outflow obstruction.

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