Department of Radiology, Division of Interventional Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Suite H-3630, Stanford, CA 94305-5642, USA.
J Vasc Interv Radiol. 2011 Feb;22(2):133-41. doi: 10.1016/j.jvir.2010.10.009.
To test the hypothesis that a common iliac vein (CIV) stenosis may impair embolization of a large deep venous thrombosis (DVT) to the lungs, decreasing the incidence of a symptomatic pulmonary embolism (PE).
Between January 2002 and August 2007, 75 patients diagnosed with unilateral DVT were included in a single-institution case-control study. Minimum CIV diameters were measured 1 cm below the inferior vena cava (IVC) bifurcation on computed tomography (CT) images. A significant stenosis in the CIV ipsilateral to the DVT was defined as having either a diameter 4 mm or less or a greater than 70% reduction in lumen diameter. A symptomatic PE was defined as having symptoms and imaging findings consistent with a PE. The odds of symptomatic PE versus CIV stenosis were assessed using logistic regression models. The associations between thrombus location, stenosis, and symptomatic PE were assessed using a stratified analysis.
Of 75 subjects, 49 (65%) presented with symptomatic PE. There were 17 (23%) subjects with a venous lumen 4 mm or less and 12 (16%) subjects with a greater than 70% stenosis. CIV stenosis of 4 mm or less resulted in a decreased odds of a symptomatic PE compared with a lumen greater than 4 mm (odds ratio [OR] 0.17, P = .011), whereas a greater than 70% stenosis increased the odds of DVT involving the CIV (OR 7.1, P = .047).
Among patients with unilateral DVT, those with an ipsilateral CIV lumen of 4 mm or less have an 83% lower risk of developing symptomatic PE compared with patients with a CIV lumen greater than 4 mm.
验证假设，即髂静脉狭窄可能会影响大隐静脉血栓向肺部的栓塞，从而降低症状性肺栓塞（PE）的发生率。
在 2002 年 1 月至 2007 年 8 月期间，对 75 例单侧深静脉血栓形成（DVT）患者进行了单中心病例对照研究。在 CT 图像上，于下腔静脉（IVC）分叉下方 1cm 处测量髂静脉（CIV）的最小直径。同侧 CIV 狭窄定义为直径 4mm 或更小或管腔直径减少 70%以上。症状性 PE 定义为有症状和符合 PE 的影像学表现。采用逻辑回归模型评估 CIV 狭窄与症状性 PE 发生的比值比（OR）。采用分层分析评估血栓位置、狭窄与症状性 PE 之间的关系。
在 75 例患者中，有 49 例（65%）出现症状性 PE。17 例（23%）患者静脉管腔为 4mm 或更小，12 例（16%）患者管腔狭窄超过 70%。与管腔大于 4mm 的患者相比，CIV 狭窄 4mm 或更小的患者发生症状性 PE 的可能性降低（比值比[OR]0.17，P=0.011），而管腔狭窄超过 70%的患者发生 CIV 血栓形成的可能性增加（OR 7.1，P=0.047）。
在单侧 DVT 患者中，与 CIV 管腔大于 4mm 的患者相比，CIV 管腔为 4mm 或更小的患者发生症状性 PE 的风险降低 83%。
