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Reduced External Iliac Venous Blood Flow Rate Is Associated with Asymptomatic Compression of the Common Iliac Veins

Yuan-Hsi Tseng1, Chien-Wei Chen2,3, Min-Yi Wong1,4

  • 1Division of Thoracic and Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, College of Medicine, Chia-Yi and Chang Gung University, Taoyuan 33302, Taiwan.

Medicina (Kaunas, Lithuania)
|August 27, 2021
PubMed

Insights

Common iliac vein (CIV) compression may not cause leg symptoms. Reduced external iliac vein (EIV) blood flow on the compressed side is linked to fewer symptoms, suggesting a protective effect.

Area of Science:

  • Vascular Medicine
  • Radiology
  • Hemodynamics

Background:

  • Common iliac vein (CIV) compression can occur without lower extremity symptoms.
  • Understanding venous blood flow changes is crucial for assessing CIV compression impact.

Purpose of the Study:

  • To investigate the relationship between CIV compression and venous blood flow using quantitative flow magnetic resonance imaging (fMRI).
  • To analyze how changes in blood flow parameters correlate with the presence or absence of lower extremity symptoms.

Main Methods:

  • Quantitative flow MRI was used to measure mean flux (MF) and mean velocity (MV) in popliteal, femoral, and external iliac veins (EIV).
  • Comparisons were made between the CIV compression side and the non-compression side in patients without deep vein thrombosis.
  • Statistical analyses, including ROC and chi-squared tests, were performed to evaluate symptom risk.

Main Results:

  • No significant differences in MF or MV were found between sides in patients with CIV compression.
  • In asymptomatic patients (n=10), the EIV MF on the compression side was significantly lower than on the non-compression side (p=0.04).
  • A percentage difference in EIV MF ≤-18.5% correlated with a reduced relative risk (0.44) of lower extremity symptoms (p=0.016).

Conclusions:

  • A decrease in EIV blood flow on the CIV compression side is associated with a lower likelihood of developing lower extremity symptoms.
  • This finding suggests a potential compensatory mechanism or altered venous hemodynamics in asymptomatic CIV compression.

Keywords:
May–Thurner syndromeQFlowTRANCE MRIcommon iliac vein compressionnon-contrast venography

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