Impact of Intravascular Ultrasound in Endovascular Interventions for Chronic Venous Insufficiency with Venous Stasis...

To determine if IVUS use in patients with chronic venous disease increases the rate of ulcer healing through identification and treatment of significant central venous stenoses not visualized on venography alone.

A retrospective review was performed of 170 patients (104 males and 66 females; mean age, 64 years) with Clinical, Etiology, Anatomy, and Pathophysiology 6 disease undergoing venography and intervention for active venous ulcers in 178 limbs at a single tertiary care center from 2010 to 2024. Patient demographics, ulcer characteristics, interventions performed, and outcomes were reviewed. Procedures with venography and with (n = 83 limbs, 47%) or without IVUS (n = 95 limbs, 53%) were compared. Analysis assessed baseline characteristics and procedural outcomes, including ulcer healing rates, symptom scores, and healthcare utilization.

Patients who underwent IVUS assessment had a higher rate of complete ulcer healing (27% vs 13%; odds ratio, 2.8; P = .02) and larger decrease in ulcer size (P < .001). There was no significant difference in Venous Clinical Severity Score (P = .08). Lower healthcare utilization was observed in the IVUS group (13 wound care visits and 24 home health visits per patient-year, versus 14 wound care visits and 38 home health visits per patient-year), although this did not reach statistical significance (P = .06).

In this retrospective cohort study, patients with active venous ulcers who underwent IVUS and venography experienced improved ulcer healing in comparison with those who underwent venography alone.