Iliac vein obstruction is something you may never have heard of, but, in reality, it’s a very common occurrence

By Laura Briedis

If you have pain and swelling in your legs, you may be suffering from a little-known disease, but one that is prevalent and highly treatable if diagnosed properly.

Called iliac vein obstruction, this large blood vessel in the pelvic region that is sandwiched between the backbone and the left or right iliac artery can get compressed, leading to blood clots and swelling in the legs.

An estimated three percent of the population, or 9.75 million, people have iliac vein obstruction.

“This chronic disease is woefully underdiagnosed,” says Michael P. Brown, DO, Director of Vascular Surgery at University Hospitals Geauga Medical Center.

“Oftentimes, patients are bounced around from their general care practitioner to specialists before they get referred to us. Patients with leg pain and swelling who go to the ER generally are checked for deep vein thrombosis (DVT), or a blood clot in the leg. When there is no life-threatening problem found, they are prescribed compression stockings or even unnecessary diuretics and sent on their way. However, many of these patients may have an obstruction in their iliac vein.”

“The main symptom is leg swelling on one side, which is three times more likely to be on the left side, but can be on either side,” Dr. Brown, who is among only a handful of physicians nationwide to specialize in iliac vein interventions, adds.

“It also affects women three times more than men. Multiple pregnancies can be a risk factor because pressure from the artery is compounded by the baby pushing on the vein, exacerbating the inflammation. Another risk factor is obesity, as it puts extra pressure on your veins.”

To fix the obstruction, Dr. Brown inserts an ultrasound probe into the blocked vein to find the narrowing of the vein and culprit lesion. Then he inserts a stent into the vein to hold it open, allowing blood to flow without resistance all the way up through the leg and back into the heart. If a blood clot is present, the patient first receives medicine to break it up.

“My goal is to catch these patients with a chronic condition who have an obstruction before they develop blood clots and life-altering problems,” says Dr. Brown “When diagnosed early, this procedure can be done in the catheterization lab as an outpatient procedure.”

Trained in this minimally invasive vascular procedure in Florida, Dr. Brown has been treating patients in Northeast Ohio for the past three years and performs several of these surgeries a month.

“I recommend that everyone who has swelling in one leg that is getting worse and/or has recurring wounds on the leg that do not heal get screened for problems with the iliac vein,” he advises.

The UH Geauga Department of Vascular Surgery also offers comprehensive care for artery disease, including people who have had strokes and blockages in the carotid arteries; abdominal aneurysms; acute and chronic venous disease; peripheral artery disease; and dialysis access for dialysis patients.

“In our community hospital, we can treat patients close to home by offering advanced procedures in our medical center without the need to travel to the downtown campus,” Dr. Brown notes.

The Department of Vascular Surgery is part of the Harrington Heart & Vascular Institute at UH Geauga Medical Center, which provides comprehensive care for heart and vascular conditions, including routine examinations, advanced surgical procedures and post-treatment follow-up. These services offer the community access to some of the country’s foremost experts in diagnostic and interventional cardiac care, cardiovascular medicine, and vascular care and surgery.

University Hospitals Geauga Medical Center is located at 13207 Ravenna Road, in Chardon. For an appointment, call 440-285-6975 or visit UHHospitals.org/services/heart-and-vascular-services/conditions-and-treatments/vascular-disease for more information.