Two Cases of Vein-to-vein Cross Bypass for Iliac Compression Syndrome with a Left Internal Iliac Arteriovenous Fistula

Abstract

We report the treatment of two cases of iliac compression syndrome (ICS) with severe complications, including hemorrhage, swelling, and a refractory skin ulcer. One patient was a 76-year-old woman with severe left leg swelling and a hemorrhage in her left thigh, due to ICS, and femoral and iliac arteriovenous fistulas. Transcatheter arterial embolization for femoral arteriovenous fistula and stent implantation for left iliac vein obstruction both failed, after which we performed a femoral vein-to-vein cross bypass with PROPATEN. The other patient was 82-year-old woman with severe left leg swelling and refractory skin ulcer due to ICS and iliac arteriovenous fistula. We performed an iliac vein-to-vein cross bypass with PROPATEN. PROPATEN is a ringed, expanded polytetrafluoroethylene(ePTFE) graft that anchors heparin to its luminal surface. Both patients showed improvement in their symptoms and graft patency was maintained with preserving the arteriovenous fistula. We suggest that the vein-to-vein cross bypass with GORE PROPATEN is an effective treatment for ICS.