The iliac vein compression syndrome. A case report with a review of the literature.

The iliac compression syndrome results from reduced venous return from the left leg due to pressure from the right common iliac artery on the underlying left common iliac vein where it enters the inferior vena cava. The pressure results in intravenous band and adhesion formation which can lead to iliofemoral thrombosis with insufficient recanalization. We present such a case in a young man who had swelling, venous claudication, siderosclerosis, and skin ulcers. The syndrome was diagnosed by pelvic phlebography, arteriography, venous emptying time, and venous pressure measurement. Palma's crossover operation was performed, in which the contralateral great saphenous vein was transposed subcutaneously to the ipsilateral common femoral vein peripheral to the obstruction. To avoid graft thrombosis, a temporary arterio-venous fistula was created. Follow-up six months after the operation showed the operative result to the satisfactory.