Mechanical Thrombectomy and Port-a-catheter Salvage in Acute Thrombotic Superior Vena Cava Syndrome

root enlargement in proximity to the iliac vein stent.Case 3: A 52-year-old female with left leg aching and anteromedial thigh pain who had hemodynamically significant left common iliac vein stenosis by venogram as correlated with IVUS.Results: Both of the patients who underwent surgical procedures and endovascular stent placement experienced relief of longstanding symptoms postoperatively.In the first patient, intraoperative hemorrhage was controlled with covered stent placement and external iliac vein ligation.The last patient did not undergo stent placement due to L5 nerve proximity to the noted stenosis on CT, and symptoms improved after laser ablation of the left great saphenous vein.Conclusions: Although the first two patients' lumbar radiculopathy improved postoperatively, these procedures were highly invasive, complex undertakings with associated morbidity.Possible techniques from the authors to avert this entity include stenting across the internal iliac vein to "lift" the stent away from the nerve, spacing stents apart to avoid an interface with the L5 nerve, or avoiding stent termination at an acute angle with the lumbar plexus.Finally, scrutiny of available cross-sectional imaging to assess the left common iliac vein relationship to the lumbar plexus should better inform procedural decisionmaking.