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Femoroiliocaval stenting has become the standard of care for patients with quality-of-life impairing chronic iliofemoral venous obstruction not responding to conservative measures. While improvement following stenting has been noted in multiple large studies, sizing of stents has been subjective in nature with a general tendency to use smaller stents that that would be required to relieve venous hypertension. This study evaluates the authors technique of using the IVUS inflow channel luminal area to guide stent sizing.