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Hemodynamic significance of collateral blood flow in chronic venous obstruction

R L M Kurstjens1, M A F de Wolf2, J H H van Laanen3

  • 1Department of Vascular Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands r.kurstjens@maastrichtuniversity.nl.

Phlebology
|March 3, 2015
PubMed

Insights

Common femoral vein pressure is elevated in deep venous obstruction, indicating collateral blood flow plays a key role in managing post-thrombotic syndrome symptoms. This highlights the importance of collateralization in venous disease management.

Area of Science:

  • Vascular Surgery
  • Hemodynamics
  • Venous Thromboembolism

Background:

  • Post-thrombotic syndrome (PTS) symptoms often don't correlate with imaging findings.
  • Collateral blood flow may explain this discrepancy in deep venous obstruction.
  • Investigating the hemodynamic impact of collateralization is crucial.

Purpose of the Study:

  • To assess the hemodynamic effect of collateral blood flow in deep venous obstruction.
  • To understand the relationship between collateralization and PTS symptom severity.

Main Methods:

  • Measured resting common femoral vein pressure in patients with unilateral iliofemoral PTS.
  • Compared pressure in affected limbs to control limbs.
  • Assessed pressure changes in controls after acute external iliac vein balloon occlusion.

Main Results:

  • Common femoral vein pressure was significantly higher in diseased limbs (17.0 mmHg) versus controls (12.8 mmHg).
  • Acute occlusion caused a greater pressure increase (23.5 mmHg) than chronic PTS.
  • Findings remained significant after adjusting for non-occlusive disease.

Conclusions:

  • Elevated common femoral vein pressure in PTS suggests significant collateralization.
  • The difference between PTS and acute occlusion pressures underscores collateral function.
  • Collateralization is vital in deep venous obstructive disease but doesn't negate treatment necessity.
Abstract

Keywords:
Collateral blood flowcommon femoral veindeep venous obstructionhemodynamic effectpost-thrombotic syndromepressure

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