Iliopsoas Bursitis Compressing an External Iliac Vein Stent

Abstract

We report a case of external iliac vein (EIV) compression due to iliopsoas bursitis. A 78-year-old man with a prior left total hip arthroplasty (THA) and left lower extremity (LLE) deep vein thrombus (DVT) presented with chronic LLE edema. Initial ultrasound examination revealed deep venous reflux and evidence of ipsilateral outflow vein obstruction. A left groin mass thought to be a hernia was noted. Conservative management was unsuccessful. Subsequent venography and intravascular ultrasound demonstrated severe stenosis of the distal EIV. A stent was placed but could not be fully expanded despite repeated venoplasty. Following the procedure, pelvic computed tomography (CT) showed extrinsic compression of the EIV and stent likely caused by iliopsoas bursitis.

Keywords

central venous stenosis May-Thurner syndrome venous compression venous insufficiency vascular ultrasound vascular technology varicose veins angioplasty iliopsoas bursitis stent

Get full access to this article

View all access options for this article.

References

Corvino

Venetucci

Caruso

, et al Iliopsoas bursitis: the role of diagnostic imaging in detection, differential diagnosis and treatment. Radiol Case Rep. 2020;15(11):2149-2152.

Avasarala

Ahsan

. Bilateral lower-extremity edema caused by iliopsoas bursal distention after hip arthroplasty. Tex Heart Inst J. 2016;43(6):550-551.

Natsume

Yamamoto

Tanaka

Hiraiwa

Tanaka

. A case of external compression of femoral vein by the enlarged iliopsoas bursa with long term edema. Ann Vasc Dis. 2015;8(2):100-102.

Beksaç

Tözün

Baktiroglu

Sener

Gonzalez Della Valle

. Extravascular compression of the femoral vein due to wear debris-induced iliopsoas bursitis: a rare cause of leg swelling after total hip arthroplasty. J Arthroplasty. 2007;22(3):453-456.

Yang

Bronson

. Cystic enlargement of the iliopsoas bursa causing venous obstruction as a complication of total hip arthroplasty: a case report. J Arthroplasty. 1993;8(6):657-661.

Jones

Economou

Adams

Bernstein

. Iliopsoas bursa presenting as deep vein thrombosis in rheumatoid arthritis. Br J Rheumatol. 1993;32(9):832-834.

Savarese

Kaplan

Calligaro

DeLaurentis

. Iliopectineal bursitis: an unusual cause of iliofemoral vein compression. J Vasc Surg. 1991;13(5):725-727.

Chaudhary

Ganguly

Rai

Kesavanarayanan

Anosike

. Thinking beyond hernia: a review of non-hernia groin lumps. Abdom Radiol (NY). 2020;45(6):1929-1949.

Seager

Busuttil

Dharmarajah

Davies

. Editor’s choice—a systematic review of endovenous stenting in chronic venous disease secondary to iliac vein obstruction. Eur J Vasc Endovasc Surg. 2016;51(1):100-120.

10.

Razavi

Jaff

Miller

. Safety and effectiveness of stent placement for iliofemoral venous outflow obstruction: systematic review and meta-analysis. Circ Cardiovasc Interv. 2015;8(10):e002772.