Role of lower extremity fasciectomy plus fasciotomy for patients with persistent leg pain after stenting for chronic iliofemoral venous obstruction

Abstract

Although clinical improvement after stenting for symptomatic iliofemoral venous obstruction has been demonstrated in multiple large studies, a small proportion of patients will experience persistent quality of life–impairing symptoms. Swelling in such a setting represents the concomitant presence of lymphedema and will respond to treatment directed at the lymphedema. In contrast, persistent pain likely arises from venous hypertension in the lower leg, leading to the development of chronic compartment syndrome. Evaluation of intracompartmental pressures in such patients can help confirm the diagnosis, and fasciectomy combined with fasciotomy will treat the issue. In the present series, we evaluated six patients (six limbs) who had undergone fasciectomy combined with fasciotomy and their outcomes.

Keywords

• Chronic compartment syndrome
• Chronic iliofemoral venous obstruction
• May-Thurner syndrome
• Post-thrombotic syndrome
• Venous hypertension