CCB Vascular Center, Cardiology Angiology Center Bethanienhospital (CCB), Frankfurt a. M., Germany.
Section of Angiology, Department of Cardiology/Cardiology I, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany.
Vasa. 2021 Jan;50(1):30-37. doi: 10.1024/0301-1526/a000933.
Deep venous thrombosis (DVT) and in particular, iliofemoral thrombosis (IFT) can lead to recurrent thrombosis and postthrombotic syndrome (PTS). Data on the prevalence, predictors and outcome of IFT are scarce. We retrospectively searched our database of outpatients who had presented with DVT and IFT including the iliac veins from 2014 until 2017. In addition, we performed a prospective registry in a subgroup of patients with IFT. These patients received duplex ultrasound, magnetic resonance venography and measurement of symptom-free walking distance using a standardized treadmill ergometry. The severity of PTS was analyzed using the Villalta-Scale (VS) and quality of life was assessed using the VEINES-QOL/Sym Questionnaire. 847 patients were retrospectively identified with DVT and 19.7% (167/847) of these presented with IFT. 50.9% (85/167) of the IFT-patients agreed to participate in the prospective registry. The majority of these patients (76.5%: 65/85) presented with left-sided IFT. In 53.8% (35/65) May-Thurner syndrome was suspected. 27.1% (23/85) underwent invasive therapy. Moderate or severe PTS (VS ≥ 10) occurred in 10.6% (9/85). The severity of PTS is correlated with a reduced quality of life (ρ (CI 95%) = -0.63 (-0.76; -0.46); p < 0.01). None of the patients presented with a venous ulcer at any time. A high body mass index was a significant predictor (OR (CI 95%) = 1.18 (1.05; 1.33), p = 0.007) for the development of clinically relevant PTS (VS ≥ 10) and venous claudication. Every fifth patient with DVT presented with an IFT. The majority developed left sided IFT. Every 10 patient developed moderate or severe PTS (VS ≥ 10). A high body mass index was predictive for the development of PTS and venous claudication.
深静脉血栓形成（DVT），特别是髂股静脉血栓形成（IFT）可导致复发性血栓形成和血栓后综合征（PTS）。关于 IFT 的患病率、预测因素和结局的数据很少。我们回顾性地检索了 2014 年至 2017 年期间因 DVT 和 IFT 就诊的门诊患者数据库，其中包括髂静脉。此外，我们在 IFT 患者亚组中进行了前瞻性登记。这些患者接受了双功能超声、磁共振静脉造影和使用标准化跑步机进行无症状行走距离测量。采用 Villalta 量表（VS）分析 PTS 的严重程度，采用 VEINES-QOL/Sym 问卷评估生活质量。我们回顾性地确定了 847 例 DVT 患者，其中 19.7%（167/847）存在 IFT。IFT 患者中有 50.9%（85/167）同意参与前瞻性登记。这些患者中的大多数（76.5%：65/85）存在左侧 IFT。53.8%（35/65）怀疑存在 May-Thurner 综合征。27.1%（23/85）接受了有创治疗。10.6%（9/85）出现中度或重度 PTS（VS≥10）。PTS 的严重程度与生活质量下降相关（ρ（95%CI）=-0.63（-0.76；-0.46）；p<0.01）。任何患者在任何时候均未出现静脉溃疡。高体重指数是发生临床相关 PTS（VS≥10）和静脉跛行的显著预测因素（OR（95%CI）=1.18（1.05；1.33），p=0.007）。每 5 例 DVT 患者中就有 1 例存在 IFT。大多数患者发生左侧 IFT。每 10 例患者中就有 1 例出现中度或重度 PTS（VS≥10）。高体重指数是 PTS 和静脉跛行发展的预测因素。
