Department of Surgery and Cancer, Imperial College London, London, UK.
Cambridge Vascular Unit, Addenbrookes Hospital, Cambridge, UK.
Vascular. 2024 Jun;32(3):705-709. doi: 10.1177/17085381231153540. Epub 2023 Jan 23.
Evidence regarding ultrasound assessment of left common iliac vein diameter (LCIV) is limited. Extensive work is currently being undertaken worldwide on non-thrombotic iliac vein lesions to identify patients who may benefit from intervention to alleviate symptoms of chronic venous obstruction. Interventions include long-term stent implantation to improve vein diameter stenosis. This study aimed to assess a cohort of symptomatic venous patients and the diameter of the LCIV in these patients.
: Retrospective medical records review of all patients attending a tertiary vascular surgery centre who underwent a venous duplex ultrasound assessment between April 2017 and February 2018 were analysed for assessment of LCIV. Medical records of those patients with documented LCIV diameter were assessed over 18 months of follow-up.
: A total of 672 (271 males, 401 females) LCIV diameter measurements were collected. The age of the patients ranged from 21 to 95 years (mean = 56.38). Median LCIV diameter overall was 7.64 mm (IQR 5.80mm-9.00 mm). 40 patients (6%) were reported to have a LCIV diameter measurement of < 4 mm, 8 (20%) male and 32 female (80%). 17 of these 40 patients (47.5%) were treated conservatively. Median LCIV diameter was 3.4 mm (IQR 2.5-3.7). 21 of these 40 patients (52.5%) underwent superficial venous intervention only, with a median LCIV diameter of 3.5 mm (IQR 3.2-3.7) and 2 out of these 40 patients (5%) underwent deep venous stenting (2/2 female - 100%), with a median LCIV diameter of 2.9 (IQR 2.9-2.9). No patients underwent both superficial and deep venous treatment in this 40 patient cohort. In those undergoing superficial venous intervention, 4 (19%) underwent repeat treatment. The two deep venous stenting patients underwent magnetic resonance venogram and venogram with intravascular ultrasound to allow stent placement, which confirmed a narrowed left common iliac vein. Primary stent patency at 18 months was 100%.
In this large study cohort of venous duplex assessments the median vein diameter was 7.64 mm and 40 patients out of 672 had a vein diameter smaller than 4 mm. 2 patients underwent deep venous stenting with primary patency of 100%.
关于左髂总静脉直径（LCIV）超声评估的证据有限。目前，全世界正在广泛研究非血栓性髂静脉病变，以确定可能受益于介入治疗以缓解慢性静脉阻塞症状的患者。干预措施包括长期支架植入以改善静脉直径狭窄。本研究旨在评估一组有症状的静脉患者和这些患者的 LCIV 直径。
对 2017 年 4 月至 2018 年 2 月期间在三级血管外科中心接受静脉双功超声评估的所有患者的病历进行回顾性分析，以评估 LCIV。对有记录的 LCIV 直径的患者病历进行了 18 个月的随访评估。
共收集了 672 例（271 例男性，401 例女性）LCIV 直径测量值。患者年龄从 21 岁到 95 岁（平均 56.38 岁）。整体 LCIV 直径中位数为 7.64mm（IQR 5.80mm-9.00mm）。40 名患者（6%）的 LCIV 直径测量值<4mm，8 名男性和 32 名女性（80%）。这 40 名患者中有 17 名（47.5%）接受了保守治疗。LCIV 直径中位数为 3.4mm（IQR 2.5-3.7）。这 40 名患者中有 21 名（52.5%）仅接受了浅静脉介入治疗，LCIV 直径中位数为 3.5mm（IQR 3.2-3.7），这 40 名患者中有 2 名（5%）接受了深静脉支架置入术（2/2 名女性-100%），LCIV 直径中位数为 2.9（IQR 2.9-2.9）。在这 40 名患者队列中，没有患者同时接受浅静脉和深静脉治疗。在接受浅静脉介入治疗的患者中，有 4 名（19%）接受了重复治疗。两名接受深静脉支架置入术的患者接受了磁共振静脉造影和血管内超声检查以允许支架放置，这证实了左髂总静脉狭窄。18 个月时，主要支架通畅率为 100%。
在这项静脉双功能超声评估的大型研究队列中，静脉直径的中位数为 7.64mm，672 名患者中有 40 名静脉直径小于 4mm。2 名患者接受了深静脉支架置入术，主要通畅率为 100%。
