More than 10% of patients may have stenosis (narrowing) of the iliac vein. In these patients, a stent (a slender tubular device) is placed in the vein to keep it open.

In the patient with acute thrombosis who has pronounced edema, cyanosis, purpura (purplish spots), or gangrene, a fasciotomy (incision of the stiff covering enclosing the four muscle compartments) is performed in the calf to release pressure and reestablish circulation.

If normal flow in the patient’s superficial femoral vein cannot be established, the incision is extended lower along the leg, restoring flow from the deep femoral vein branches with a Fogarty catheter. Then the superficial femoral vein is ligated.