Management of Cases Where Lower Limb Lymphoedema was Misdiagnosed as Iliac Vein Compression Syndrome

Unilateral lower extremity lymphedema may be clinically misdiagnosed as iliac vein compression syndrome, leading to stent implantation. This study summarizes themanagement of cases where lower extremity lymphedema was misdiagnosed as iliac vein compression syndrome. A retrospective analysis was conducted on the edema reduction outcomes of 11 patients with secondary lymphedema who had been previously undergone iliac vein stent implantation. After these patients presented for subsequent visit and were diagnosed with lymphedema, they were treated with various therapies tailored to their specific stages of lymphedema, including complex decongestive therapy, lymphovenous anastomosis, or a combination of liposuction and lymphovenous anastomosis. Follow-up assessments of limb morphology and Lymphedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphedema scores were conducted 3, 6, and 12 months post-treatment. After iliac vein stent implantation, partial relief of limb swelling was observed in six patients with stage I and IIa lymphedema, but the swelling recurred and worsened within 3 months. The remaining patients did not experience any relief of limb swelling following stent implantation. Upon revisit, four patients with Stage I and IIa lymphedema underwent complex decongestive therapy, four patients with Stage I and IIa lymphedema received lymphovenous anastomosis, and the remaining three patients with Stage IIb lymphedema underwent liposuction combined with secondary lymphovenous anastomosis. Iliac vein stent implantation does not prevent the progression of limb swelling in patients with secondary lymphedema complicated by iliac vein compression. Complex decongestive therapy, lymphovenous anastomosis, or liposuction can achieve good therapeutic outcomes for these patients.