Objective To investigate the short-term efficacy and clinical safety of pharmacomechanical catheter-directed thrombolysis(PCDT)combined with Venovo(Bard)venous stent implantation in treating iliac vein compression syndrome(IVCS)associated with acute lower extremity deep venous thrombosis(DVT).Methods The clinical data of 23 IVCS patients with acute DVT,who received PCDT combined with Venovo venous stent implantation at the Fifth Affiliated Hospital of Zhengzhou University of China between July 2022 and December 2022,were retrospective analyzed.The differences in preoperative and postoperative lower limb circumference and the postoperative thrombus clearance rate were evaluated.Outpatient follow-up was conducted at one,3,and 6 months after treatment,and the patient's venous clinical severity score(VCSS)was recorded and the stent patency was checked.Results Successful surgery was achieved in all 23 patients,and the target lesion thrombus was completely cleared(clearance ratio＞95％).A total 23 Venovo iliac vein stents were implanted during the same period.During the follow-up period of 6 months,neither displacement,fracture or detachment of the stent nor death occurred.In the 23 patients,the circumference differences of thigh and calve between the affected and healthy lower limbs decreased from preoperative(5.59±0.93)cm and(3.52±0.85)cm respectively to postoperative(1.43±0.68)cm and(1.41±0.72)cm respectively,the differences were statistically significant(both P＜0.05).Six months after treatment,the VCSS significantly decreased from preoperative(8.0±1.9)points to postoperative(5.4±1.1)points,the difference was statistically significant(P＜0.05),the primary patency rate was 95.7％(22/23),and the surgical re-intervention rate was 4.3％.Conclusion For the treatment of IVCS complicated by acute lower extremity DVT,combination use of PCDT and Venovo venous stenting is clinically safe and effective,therefore,this technique carries good prospect of clinical application.(J Intervent Radiol,2024,33:627-632)