Intravascular Ultrasound (IVUS) And Iliac Vein Stenting

Advances in vein imaging technology (Intravascular Ultrasound – “IVUS”) have recently allowed vein specialists to diagnose a group of serious, but treatable, medical conditions which, until now, were greatly under-recognized. 

The blood in our leg veins, returning to the heart, has to pass through large veins in the pelvis called iliac veins.  While actual blood clots in the iliac veins are relatively easy to diagnose and treat, most iliac vein problems are due instead to either chronic vein scarring or compression (May Thurner Syndrome) which have been (until now) difficult to diagnose using standard tests such as ultrasound, CT scans, or even venograms (dye injection). 

Vein specialists have long been at a loss on how to treat many patients who have the typical findings of severe vein disease (skin discoloration, swelling, leg ulcers, etc) but who have nothing wrong on the leg ultrasound or have persistent symptoms after successful treatment of the varicose veins. This has left many suffering patients, and perplexed doctors, without a satisfactory solution to the problem.  

Now things have changed.  There is a technology called Intravascular Ultrasound (IVUS) which is a very thin catheter with a tiny ultrasound probe at the tip. Under a local anesthetic and a small needle, the IVUS can be inserted into blood vessels and allows physicians to actually see the inside of veins and arteries with amazing precision.  Over the last few years physicians have been using IVUS to look at the iliac veins and have discovered that many patients suffering from swelling, skin discoloration, and ulceration of the legs have previously unrecognized severe narrowing of the iliac veins as the cause. 

 
The news gets even better. Not only does IVUS allow us to diagnose this problem easily and safely, but we can fix these narrowed iliac veins at the same time by immediately placing a stent in the vein – as just another part of the IVUS test.  Stents have been used for decades to treat narrowed blood vessels.  Stents are flexible metal mesh tubes which are inserted into the vein, pushed open with an angioplasty balloon, and remain in the vein holding it open.  The vast majority of patients who get iliac vein stents see a remarkable improvement or resolution of their problem. 

 
And even better, here at Advanced Vascular, we can provide our patients with IVUS and vein stenting in the comfort and convenience of our Morristown office.  Our patients spend a few hours with us and then are sent home the same day with immediate return to normal activity. 

If you think you might benefit from IVUS testing, give us a call for a consultation.