Iliac venous stenting as adjunct in the management of symptomatic orthostatic hypotension in iliac vein compression

Abstract

Orthostatic hypotension (OH) is a common cardiovascular disorder with high prevalence in the elderly. Concomitant venous return impairment may worsen the autonomic response and accentuate the symptoms. We detailed a patient with severe OH, prominent varicosities, and hemosiderin deposition in lower limbs. After excluding autonomic and neurological etiology, a computed tomography venography revealed significant common iliac vein compression. The patient was deemed to benefit from venous stenting. At a 2-year follow-up, the patient reported symptom improvement with adequate stent patency. Venous stenting may aid in the treatment of patients with severe OH symptoms without clear etiology and impairment of venous return.

Keywords

• Iliac stenting
• Iliac vein compression
• Orthostatic hypotension
• Postural orthostatic tachycardia syndrome