Consensus Statement on the Management of Nonthrombotic Iliac Vein Lesions From the VIVA Foundation, the American Venous Forum, and the American Vein and Lymphatic Society.

A nonthrombotic iliac vein lesion is defined as the extrinsic compression of the iliac vein. Symptoms of lower extremity chronic venous insufficiency or pelvic venous disease can develop secondary to nonthrombotic iliac vein lesion. Anatomic compression has been observed in both symptomatic and asymptomatic patients. Causative factors that lead to symptomatic manifestations remain unclear. To provide guidance for providers treating patients with nonthrombotic iliac vein lesion, the VIVA Foundation convened a multidisciplinary group of leaders in venous disease management with representatives from the American Venous Forum and the American Vein and Lymphatic Society. Consensus statements regarding nonthrombotic iliac vein lesions were drafted by the participants to address patient selection, imaging for diagnosis, technical considerations for stent placement, postprocedure management, and future research/educational needs.
Competing Interests: Dr Desai reports consulting: W.L. Gore, Shockwave Medical, Asahi Intecc, Veryan, Cordis, Surmodics, CSI, Cook Medical, Boston Scientific, Becton Dickinson/CR Bard, Medtronic, Penumbra, Tactile Medical, and Philips; and speakers’ bureau: Cook Medical, Boston Scientific, Becton Dickinson/CR Bard, Medtronic, Penumbra, Tactile Medical, and Philips. Dr Elias reports consulting: AngioDynamics, Becton Dickinson (BD), Boston Scientific, Cook Medical, Crossfire Medical, Elastimed, Medtronic, Philips, Sun Scientific, Theraclion, USA Therm, VVT Medical, and VB Devices; and stock/ownership: USA Therm, VVT Medical, VB Devices, and Enveno (stock options). Dr Gagne reports consulting: Cook Medical, Phillips, Medtronic, and Boston Scientific; speakers’ bureau: Cook Medical and Medtronic; and research support: Philips. Dr Garcia reports consulting: Philips & Vesper Medical; and stock/ownership: Vesper Medical. Dr Gibson reports consulting: Boston Scientific, Gore, Medtronic, Philips, and Koya; speakers’ bureau: Janssen; and research support: Medtronic, Gore, and Boston Scientific. Dr Kiguchi reports speakers’ bureau: Medtronic and Boston Scientific. Dr Kolluri reports consulting: Abbott, Auxetics, Diachii Sankyo, Koya Medical, Medtronic, NAMSA, Penumbra, Philips, Surmodics, USA Therm, and VB Devices. Dr Mathews reports consulting: Philips, Boston Scientific, Innova Vascular, Akura, Contego, Reflow Medical, Medtronic, Bolt, Shockwave, Fastwave, Insera, Inquis, and Endologix; speakers’ bureau: Philips, Boston Scientific, Penumbra, Cordis, Cardiva, Reflow Medical, and Shockwave; stock/ownership: Contego, Akura, Innova Vascular, Protexa, and Reflow Medical; and research support: Boston Scientific, Penumbra, Contego, Philips, Reflow Medical, Trireme, Abbott, and Recor. Dr Murphy reports consulting: BD/Bard, Boston Scientific, Cook, Cordis, Gore, Medtronic, and Philips; speakers’ bureau: BD/Bard, Boston Scientific, Cook, Medtronic, and Philips; and research support: BD/Bard, Gore, Medtronic, and Mercator. Dr Sabri reports consulting: Boston Scientific, Medtronic, and Retriever Medical; research support: Inquis Medical; and data safety monitoring board: Alucent Medical. Dr Secemsky reports consulting: Abbott, BD, Boston Scientific, Bristol Myers Squibb, Cagent, Conavi, Cook, Cordis, Gore, InfraRedx, Medtronic, Philips, Recor, Shockwave, Siemens, and Terumo and VentureMed; speakers’ bureau: Abbott, BD, Boston Scientific, BMS, Cagent, Conavi, Cook, Cordis, Gore, InfraRedx, Medtronic, Philips, Recor, Shockwave, Siemens, and Terumo and VentureMed; research support: National Institutes of Health/National Heart, Lung, and Blood Institute K23HL150290, and Food & Drug Administration, Society for Cardiovascular Angiography and Interventions; grants to institution: Abbott, BD, Boston Scientific, Cook, Medtronic, and Philips. Dr Ting reports consulting: Boston Scientific and research support: Boston Scientific.