Department of Clinical Physiology and Nuclear Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, Hellerup, Denmark.
Department of Vascular Surgery, Rigshospitalet and Gentofte Hospital, Copenhagen, Denmark.
Eur J Vasc Endovasc Surg. 2019 Oct;58(4):570-575. doi: 10.1016/j.ejvs.2019.06.016. Epub 2019 Aug 31.
The aim was to assess the anatomical distribution of acute deep venous thrombosis (DVT) with a focus on iliofemoral DVT, and, in particular, to characterise thrombus in the common femoral vein (CFV) and the deep femoral vein (DFV).
A one year prospective study including patients older than 18 years of age with an acute first time DVT according to ultrasound examination at one of three university hospitals in Copenhagen, Denmark. Thrombus location and extent were registered and divided into five segments: calf veins; popliteal vein; femoral and deep femoral vein; common femoral vein; and iliac veins and/or the inferior vena cava. Thrombus appearance of the CFV and the DFV (partial or occlusive) was examined in detail.
Acute DVTs were identified in 203 extremities in 200 patients (58% male). The median age of the patients was 68 years (range 19-92 years), and left-sided DVT was observed in 56%. Iliofemoral DVT was present in 54 (27.0%) patients. Thrombus involving the CFV but not the iliac veins (CFV group) was seen in 28 patients; the remaining 26 had involvement of the iliac veins (iliac group). Thrombus in the CFV was more likely to be occlusive in the iliac group than in the CFV group (77% vs. 4%; p < .001). Thrombus in the DFV was more often occlusive in the iliac group than in the CFV group (81% vs. 11%; p < .001). The DFV was free of thrombus in 12% of patients in the iliac group and in 64% of those in the CFV group.
The presence of occlusive thrombus in the CFV and/or in the DFV pointed to a DVT also involving the ipsilateral iliac veins. Thrombosis of the deep leg veins extending into the CFV below the inguinal ligament was more likely to be partial in the CFV, mainly due to inflow from the DFV.
评估急性深静脉血栓（DVT）的解剖分布，重点关注髂股 DVT，特别是股总静脉（CFV）和股深静脉（DFV）中的血栓特征。
这是一项为期一年的前瞻性研究，纳入了丹麦哥本哈根三家大学医院中年龄大于 18 岁的首次急性 DVT 患者。记录血栓位置和范围，并分为五个节段：小腿静脉；腘静脉；股和股深静脉；股总静脉；髂静脉和/或下腔静脉。详细检查 CFV 和 DFV（部分或完全）的血栓外观。
共在 200 名患者的 203 侧肢体中发现急性 DVT（58%为男性）。患者的中位年龄为 68 岁（19-92 岁），左侧 DVT 占 56%。54 例（27.0%）患者存在髂股 DVT。28 例患者仅累及 CFV（CFV 组），其余 26 例患者累及髂静脉（髂静脉组）。髂静脉组 CFV 中的血栓更可能为完全闭塞型，而 CFV 组则以部分闭塞型为主（77% vs. 4%；p<0.001）。髂静脉组中 DFV 中的血栓更常为完全闭塞型，而 CFV 组中则以部分闭塞型为主（81% vs. 11%；p<0.001）。髂静脉组中有 12%的患者 DFV 无血栓，而 CFV 组中则有 64%的患者 DFV 无血栓。
CFV 和/或 DFV 中存在闭塞性血栓提示同侧髂静脉也存在 DVT。延伸至腹股沟韧带以下 CFV 的深静脉血栓形成，CFV 中的血栓更可能为部分闭塞型，主要是由于来自 DFV 的血流流入。
