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Iliac Vein Compression Syndrome (IVCS): An Under-Recognized Risk Factor for Left-Sided Deep Venous Thrombosis (DVT)

Junfeng Liu1, Pengcheng Liu1, Kuo Xia1

  • 1Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China (mainland).

Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
|May 2, 2017
PubMed

Insights

Iliac vein compression syndrome (IVCS) is a significant risk factor for left-sided deep venous thrombosis (DVT) in hip fracture patients. Treatment for DVT complicated by IVCS requires more than anticoagulation alone for optimal outcomes.

Area of Science:

  • Vascular Surgery
  • Orthopedic Surgery
  • Thrombosis Research

Background:

  • Hip fracture patients are at risk for deep venous thrombosis (DVT).
  • Iliac vein compression syndrome (IVCS) may influence DVT development and treatment.
  • The role of IVCS in left-sided DVT in this population is not well-defined.

Purpose of the Study:

  • To determine if IVCS is a risk factor for left-sided DVT in hip fracture patients.
  • To assess the impact of IVCS on DVT treatment strategies and outcomes.

Main Methods:

  • Retrospective analysis of 424 hip fracture patients (2011-2016).
  • Classification into DVT and non-DVT groups using D-Dimer and Doppler ultrasound.
  • Diagnosis of IVCS based on 50% left iliac vein constriction on venography.
  • Comparison of IVCS prevalence and DVT treatment outcomes between groups.

Main Results:

  • IVCS was diagnosed in 34.3% of DVT patients versus 23.6% of non-DVT patients (P=0.02).
  • The incidence of symptomatic DVT was higher in patients with IVCS (30.0%) compared to those without (11.9%) (P=0.002).
  • No significant differences in age, sex, fracture type, or risk factors between DVT and non-DVT groups.

Conclusions:

  • IVCS is an under-recognized risk factor for left-sided DVT in hip fracture patients.
  • Anticoagulation alone is insufficient for treating DVT when complicated by IVCS.
  • More aggressive interventions are necessary for favorable outcomes in DVT patients with IVCS.

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