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Haemodynamic study of left nonthrombotic iliac vein lesions: a preliminary report
Yun Pei1, Qijia Liu1, Xuan Li2
1Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, 49 North Huayuan Road, Haidian District, 100191, Beijing, China.
Insights
Nonthrombotic iliac vein lesions (NIVLs) cause chronic venous insufficiency. Hemodynamic assessment of the left common iliac vein (LCIV) effectively reflects stenosis severity and clinical symptoms in patients with NIVLs.
Area of Science:
- Vascular Surgery
- Medical Imaging
- Hemodynamics
Background:
- Nonthrombotic iliac vein lesions (NIVLs) are a primary cause of chronic venous insufficiency (CVI) in the left lower limb.
- NIVLs also contribute to symptom recurrence after varicose vein treatment in the left lower limb.
Purpose of the Study:
- To investigate the hemodynamic and morphological characteristics of iliac veins in patients diagnosed with NIVLs.
- To establish correlations between these characteristics and the clinical severity of CVI.
Main Methods:
- Analysis of pressure, blood flow velocity, and wall shear stress within the stenotic left common iliac vein (LCIV) segment.
- Evaluation of relative blood retention time and pressure/velocity differences across the stenosis.
- Correlation of hemodynamic parameters with cross-sectional area stenosis rate and stenotic segment length.
Main Results:
- Positive correlations were observed between clinical CVI classification and pressure, blood flow velocity, and time-averaged wall shear stress in the stenotic LCIV segment.
- Negative correlation found between clinical CVI classification and relative retention time.
- Strong positive correlations between clinical classification and pressure difference (∆P), velocity difference (∆V), cross-sectional area stenosis rate, and stenotic LCIV segment length.
Conclusions:
- Hemodynamic assessment of the iliac vein accurately portrays blood flow disturbances in stenotic LCIV segments.
- Hemodynamic indicators effectively reflect the degree of iliac vein stenosis and correlate with the severity of CVI symptoms.
Abstract:
Nonthrombotic iliac vein lesions (NIVLs) are significant causes of chronic venous insufficiency (CVI) in the left lower limb and symptom recurrence following left lower limb varicose vein treatment. The goal of this study was to explore the haemodynamic and morphological characteristics of iliac veins in patients with NIVLs. Pressure at the caudal end of the stenotic left common iliac vein (LCIV) segment, local blood flow velocity, and time-averaged wall shear stress in the stenotic segment exhibited positive correlations with the clinical CVI classification (R = 0.92, p < 0.001; R = 0.94, p < 0.001; R = 0.87, p < 0.001), while the relative retention time showed a negative correlation (R = -0.94, p < 0.001). The pressure difference (∆P) between the two ends of the stenotic segment and the velocity difference (∆V) between the stenotic segment and the caudal end were positively correlated with the clinical classification (R = 0.92, p < 0.001; R = 0.9, p < 0.001). The cross-sectional area stenosis rate and length of the stenotic LCIV segment were positively correlated with the clinical classification (R = 0.93, p < 0.001; R = 0.63, p < 0.001). The results suggest that haemodynamic assessment of the iliac vein could effectively portray blood flow disturbances in stenotic segments of the LCIV, potentially reflecting the degree of iliac vein stenosis. Haemodynamic indicators are correlated with the severity of clinical CVI symptoms.
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