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Iliac Vein Compression Syndrome in an Asymptomatic Patient Population: A Prospective Study.

ABSTRACT: Iliac vein compression syndrome (IVCS) is an important cause of deep vein thrombosis, but the incidence of IVCS is still unclear. The purpose of this prospective study was to determine the incidence of IVCS in an asymptomatic patient population and to evaluate the risk factors in patients with and without IVCS.From October 2011 to November 2012, a total of 500 patients (228 women and 272 men; mean age of 55.4 ± 14.7 years) with no vascular-related symptoms were enrolled in this study. Computed tomography was performed to evaluate all patients. The degree of venous compression was calculated as the diameter of the common iliac vein at the site of maximal compression divided by the mean diameter of the uncompressed proximal and caudal left common iliac vein (LCIV). We compared the stenosis rate of the common iliac vein in women and men according to age and followed up patients to evaluate outcomes.The mean compression degree of the LCIV was 16% (4%, 36%); 37.8% of patients had a compression degree ?25% and 9.8% had a compression degree ?50%. There was a significant difference between men and women in the LCIV compression degree (9% [3%, 30%] vs. 24% [8%, 42%]; U = 4.66, P< 0.01). In addition, the LCIV compression degree among younger women (?40 years) was significantly different compared with that in older women (>40 years) (42% [31%, 50%] vs. 19% [5%, 39%]; U = 5.14, P< 0.001). Follow-up was completed in 367 patients with a mean follow-up of 39.5 months (range, 6-56 months). The incidence of IVCS in the follow-up period was 1.6%. Stenosis rate and the diameter of the site of maximal compression correlated with the incidence of IVCS. Multivariable Cox regression analysis showed that the stenosis rate was an independent risk factor of IVCS (Wald ?2 = 8.84, hazard ratio = 1.13, P< 0.001).The incidence of IVCS was low and correlated with the stenosis rate of iliac vein. Preventative therapy may be warranted for common iliac vein compression in patients at an increased risk of venous thromboembolism, especially patients with a higher iliac vein compression degree.

SUBMITTER: Cheng L

PROVIDER: S-EPMC5455034 | biostudies-other | 2017 Jun

REPOSITORIES: biostudies-other

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Iliac Vein Compression Syndrome in an Asymptomatic Patient Population: A Prospective Study.

Cheng Long L Zhao Hui H Zhang Fu-Xian FX

Chinese medical journal 20170601 11

<h4>Background</h4>Iliac vein compression syndrome (IVCS) is an important cause of deep vein thrombosis, but the incidence of IVCS is still unclear. The purpose of this prospective study was to determine the incidence of IVCS in an asymptomatic patient population and to evaluate the risk factors in patients with and without IVCS.<h4>Methods</h4>From October 2011 to November 2012, a total of 500 patients (228 women and 272 men; mean age of 55.4 ± 14.7 years) with no vascular-related symptoms were ...[more]

PMID: 28524824

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Project description:BackgroundIliac vein compression syndrome (IVCS) is an underlying cause of varicose vein (VV) recurrence after venous surgery. However, the management of recurrent varicose veins (RVVs) combined with IVCS has rarely been reported. This study aimed to investigate the outcomes of a one-stop procedure to correct outflow obstruction and superficial reflux for patients with RVVs and IVCS.MethodsA retrospective analysis was conducted of 102 consecutive patients diagnosed with RVVs. Computed tomography venography (CTV) was performed to confirm IVCS. The cases were divided into 2 groups: the IRVVs group, including patients with RVVs and IVCS (n=48), and the RVVs group, including patients with RVVs only (n=54). The characteristics, vein reflux, and clinical, etiological, anatomical, and pathophysiological (CEAP) distribution were investigated. Then, the IRVVs group patients who underwent endovenous laser ablation (EVLA) (n=39) were divided into a further 2 groups: the EVLA + S group (n=19), who received EVLA and stenting of iliac vein, and the EVLA group (n=20), who received EVLA treatment alone. The great/small saphenous vein (GSV/SSV) trunk occlusion, VV recurrence, visual analogue scale (VAS), and venous clinical severity score (VCSS) were investigated.ResultsThe prevalence rate of femoral vein reflux was 81.2% in IRVVs group and 50% in RVVs group (P<0.05). In the IRVVs group, 72.9% of patients manifested as CEAP clinical class >3, which was higher than that in RVVs group (48.1%) (P<0.05). The 12-month GSV/SSV occlusion rate in the EVLA + S and EVLA groups were 94.7% and 90.0%, respectively. Totals of 9 patients in EVLA + S group and 6 patients in EVLA group had active venous ulcers, and the ulcer healing time in EVLA + S group was significantly shorter (27.22±7.12 vs. 46.67±9.83 days, P<0.05). The reductions in the VAS and VCSS values between baseline, 1 month, and 12 months in the EVLA + S group were more obvious than those in EVLA group (P<0.05).ConclusionsThe one-stop combination treatment of iliac venous stenting and EVLA in patients with RVVs and IVCS is safe and effective and provides prominent symptom relief, improved quality of life, and a more satisfactory ulcer healing than EVLA alone.

Dataset Information

Iliac Vein Compression Syndrome in an Asymptomatic Patient Population: A Prospective Study.

Publications

Iliac Vein Compression Syndrome in an Asymptomatic Patient Population: A Prospective Study.

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