TREATMENTS › VENOUS
Deep Venous Disease Treatment — IVUS-Guided Iliac Vein Stenting
When a deep vein in the pelvis — most often the iliac vein — is squeezed or scarred shut, blood struggles to leave the leg. Reopening that vein with a stent restores the outflow, and in most cases you go home the same day.
What it treats
-
Iliac vein compression (May-Thurner) — a common, underdiagnosed cause of one-sided (usually left) leg swelling. Iliac Vein Compression Syndrome →
-
Post-thrombotic narrowing — scarring after a prior DVT.
-
Other deep (iliofemoral) obstruction causing chronic outflow problems.
We confirm it’s real before we treat it
Through a small puncture, we map the vein with venography and then look from the inside with intravascular ultrasound (IVUS) — a tiny ultrasound on the catheter tip that measures the vein directly and shows compression an outside picture misses. A 2024 expert consensus of six specialty societies rates IVUS appropriate at every step of this work, because a plain contrast picture underestimates how tight the narrowing really is. We place a stent only when the blockage is genuinely significant.
When a stent is the right choice
-
Stenting helps the right patient — not everyone with a narrowing on a scan needs one. We recommend it when these line up:
-
Symptoms significant enough to affect daily life, and clearly coming from the vein (swelling, heaviness, venous claudication, skin changes, or an ulcer)
-
A genuinely significant blockage confirmed on IVUS — not just a mild compression seen on a scan
-
Good vein inflow below the blockage for the stent to drain
-
Able to take the blood-thinning plan that keeps the stent open
-
Symptoms that haven’t settled with compression, wound care, and treating any superficial-vein reflux first
What to expect
The procedure is done through a small needle puncture — no surgical incision — under local anesthesia with light sedation, and usually takes about one to two hours. We map the vein, confirm the narrowing with IVUS, open it with a balloon, and place a dedicated self-expanding venous stent built to hold up against the outside pressure. A final IVUS check confirms the stent is fully open. Most patients go home the same day; more complex or clot-related cases may stay overnight.
Recovery & follow-up
The first week
-
Rest at the puncture site for a few hours, then gentle walking
-
Take it easy for about 5–7 days — light walking is good; avoid heavy lifting and strenuous exercise
-
Wear graduated compression stockings daily, typically for at least 4–6 weeks (longer if swelling or skin changes persist)
-
Elevate the leg when resting; no driving for 24–48 hours after sedation
Keeping the stent open
A blood-thinning plan protects the stent while it heals — tailored to you. Pure-compression cases often need only a short course; cases involving a past clot need a longer, sometimes indefinite plan. We follow the stent with ultrasound over the first year and beyond, and taking the medicines as prescribed is the single most important thing you can do to keep it working.
Frequently asked questions
For referring providers — We welcome referrals for chronic one-sided leg swelling, suspected iliac vein compression (May-Thurner), post-thrombotic syndrome, and venous ulcers not responding to conservative care. Refer: (918) 943-5303 · fax (855) 312-3594.
Refer urgently: a suddenly painful, swollen, red leg (to exclude acute DVT) · Routinely: chronic one-sided swelling or recurrent varicose veins for venous evaluation. Full referral guide →