Story

This model represents a patient who is laying flat on their back. This part of the patient's body would be at the top of the leg, as the leg connects to the main part of the body. The veins are tubes which carry the blood from the legs up through the pelvis, the abdomen, and then back up to the heart. Patients who have narrowing or blockages within their veins can have severe problems with their legs with swelling, pain, heaviness, and develop sores that are difficult to heal. What we are able to do with this technology called intravascular ultrasound, or IVUS for short, is to look inside the veins and actually see the areas of narrowing and also understand why the narrowing developed, either due to scar tissue or to pressure on the veins due to adjacent structures such as arteries or tumors. Once we identify through this imaging that there's a problem, it then helps us to place a stent which allows us to repair the vein in an outpatient setting. We now will show the catheter is up in the abdomen, in the vein here, and we're going to pull the catheter down towards the leg so that we can see where the problems are. As I start to pull the catheter back, we see a branch coming off there. We're in the main lumen, which is the inferior vena cava. Now we're coming into the common iliac vein. We see a very tight narrowing there, and then we see the normal vein just below it. So this is what the vein should look like, a tube carrying blood. And then as we come down, we see another branch coming off, and now we're coming into the top of the leg here. This is the essential information we get in order to accurately and properly treat a patient. This is the catheter in the model that represents the inferior vena cava, or the main vein in the abdomen and pelvis. As we pull it down towards the legs, we see that there are two branches here. One goes to the right leg and one goes to the left leg. We're now coming down into the left leg, veins that are in the pelvis. And we see here, the vein is narrowed. This is called a compression lesion, or a May-Therner lesion, and that can limit the blood flow out of the leg. You can see how tight of a narrowing that is. This can happen in up to 20% of the population. And then as we pull the catheter a little lower in the pelvis down towards the leg, we see that the vein becomes normal again. This is a branch from the vein here and now we're going into the vein in the upper leg. When we have a narrowing like that, we can stent that narrowing and open it up and cure the patient of their problems due to vein disease.