Related Experiment Videos
Hemodynamic changes in iliofemoral disease
Rlm Kurstjens1, Maf de Wolf2, R de Graaf3
1Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands CARIM, School for Cardiovascular Diseases, Maastricht, The Netherlands ralph.kurstjens@gmail.com.
Insights
Measuring pressure in the common femoral vein, not the dorsal foot vein, may identify iliofemoral deep venous obstruction from post-thrombotic disease. This aids in determining treatment needs for venous outflow obstruction.
Area of Science:
- Vascular Surgery
- Hemodynamics
- Venous Thromboembolism
Background:
- Iliofemoral venous obstruction from post-thrombotic syndrome (PTS) impacts quality of life.
- Percutaneous angioplasty and stenting offer treatment but lack defined hemodynamic indicators for intervention.
- Investigating hemodynamic changes in PTS is crucial for treatment guidance.
Approach:
- Study involved four patients with post-thrombotic deep venous obstruction.
- Pre-operative intravenous pressure measurements were taken in the common femoral and dorsal foot veins bilaterally.
- Ambulatory pressure was assessed during treadmill exercise with increasing incline.
Key Points:
- Common femoral vein pressure was significantly higher in post-thrombotic limbs compared to controls.
- Ambulatory pressure increased more in post-thrombotic limbs during exercise.
- Dorsal foot vein pressure showed no significant difference between affected and unaffected sides.
Conclusions:
- Common femoral vein pressure measurement may identify significant outflow obstruction in PTS.
- Dorsal foot vein pressure is not a reliable indicator for iliofemoral venous obstruction.
- Further patient inclusion is needed to validate these preliminary findings on hemodynamic parameters.
Background:
Iliofemoral venous obstruction, caused by post-thrombotic disease, can be treated by percutaneous angioplasty and additional stenting with good results. However, no hemodynamic parameter determining the need for treatment has been defined. This article describes the preliminary results of a study investigating the pressure changes occurring in post-thrombotic deep venous obstruction.
Methodology:
Four patients with post-thrombotic deep venous obstruction of the iliofemoral tract were identified. Intravenous pressure was pre-operatively measured in the common femoral vein and in a dorsal foot vein bilaterally. During these pressure measurements patients were asked to walk on a treadmill with a speed of 3.2 km/h and a zero per cent slope, with the slope increasing two per cent every two minutes.
Results:
Four patients (two male, two female) with age varying from 23 to 40 were identified. In two patients, disease extended below the femoral confluence. Pressure in the dorsal foot vein was not notably different between the affected and the control side. Pressure in the common femoral vein was markedly higher in post-thrombotic limbs compared to the control limb, with ambulatory pressure increasing more in post-thrombotic limbs.
Conclusions:
These preliminary results are highly illustrative for the hemodynamic effect of iliofemoral deep venous obstruction due to post-thrombotic disease, even though sample size is admittedly limited. Furthermore, these results suggest that pressure measurements of the common femoral vein, and not the dorsal foot vein, might be able to identify a significant outflow obstruction due to post-thrombotic disease, though further inclusion of patients is necessary.