Leg swelling is a difficult symptom to diagnose. There is a long list of underlying causes for leg swelling and it is important to note two things:
1. Is the leg swelling unilateral (in one leg) or is it in both?
If it is in both, it is more likely to be a “systemic” issue, that is a problem with one’s general health. This can be something as simple as too much time in a chair, to something as serious as congestive heart failure. Many medications can also contribute to bilateral leg swelling as can liver disease, kidney problems, and obesity.
2. What part of the leg is swollen?
If the swelling extends into the foot, it is more likely to be lymphedema than a venous problem.
If it goes all the way up into the thigh it may be Iliac Vein Compression or, if the onset of swelling is rapid, it may be the result of an ileofemoral blood clot (DVT).
It is important not to ignore leg swelling, especially if it comes on abruptly as it may be a sign of a serious and potentially life threatening issue.
Iliac vein compression syndrome occurs because of the anatomic compression of the left iliac vein between the lumbar spine and the right iliac artery. Although originally thought to be a rare syndrome, it is now believed that about 30% of all people have significant compression of their iliac vein. In most people, this is asymptomatic and will never cause a problem. However, it is being recognized that in more people who have chronic leg swelling, especially of the left side, continued aching despite treatment of superficial venous disease, recurrent left leg blood clots, and /or nonhealing ulcerations at the ankle or shin that this compression prevents the adequate drainage of blood from the leg. Although about 80% of the compressions are of the left iliac vein, we do sometimes find them on the right, especially as a result of scarring from pelvic or back surgery. This is the most common cause of ileofemoral DVT and should be worked up aggressively.
This is a special area of interest of ours, and we are active in doing clinical research to find better ways to diagnose and to treat iliac vein compression. Unfortunately, many physicians are unaware of these latest treatment options and tell their patients that not much can be done to treat this condition. Consequently, we find that way too many patients live with this painful and difficult condition of leg swelling and the non-healing wounds that often accompany it. There is hope.
We can help.
The physicians at South Bay Vascular Center and Vein Institute are board certified vascular surgeons and not “phlebologists” or “vein specialists”. As such we can do significantly more to treat generalized leg swelling and the leg swelling that often accompanies failed cosmetic vein procedures. Our surgeons are at the forefront of diagnosing iliac vein compression and leg swelling secondary to cosmetic procedures using regular vascular ultrasound. Most importantly, we can treat this painful condition with the newest endovascular techniques using IVUS (intravascular ultrasound) and stents in an outpatient office setting. To date, we have successfully treated over 75 patients in our outpatient angio suite here in Campbell, CA. If you suffer from leg swelling, especially left leg swelling there is hope. Please give us a call at South Bay Vascular Center and Vein Institute to schedule an appointment to discuss your treatment options. 408-376-3626