Xu Yingjiang, Wu Jian, Cheng Yongjia, Chen Gang, Han Xinqiang, Sheng Yuguo, Wu Xuejun, Wang Wenming
Department of Interventional Vascular Surgery, Binzhou Medical University Hospital, Binzhou, Shandong, China.
Department of Vascular Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Front Cardiovasc Med. 2023 Feb 3;10:1088224. doi: 10.3389/fcvm.2023.1088224. eCollection 2023.
The purpose of this study was to determine the technical feasibility and safety of 3D rotational venography (3D-RV) in the diagnosis of non-thrombotic iliac vein lesions compared with traditional 2D-digital subtraction angiography (2-DSA).
The general epidemiological data (including age, gender), clinical manifestations (including major symptom, affected extremity, CEAP classification, comorbidity, stenosis rate), and intra-operative findings (iliac vein indentation position, collateral circulation, procedure time, X-rays dose, contrast agent dosage) of 61 NIVL patients who were assessed by 3D-RV and traditional 2-DSA between October 2018 to October 2022 were obtained and analyzed.
A total of 61 consecutive patients with symptomatic NIVL from our institution were enrolled in this study. With the aggravation of iliac vein stenosis, the proportion of indicators such as contralateral formation and iliac vein compression indentation reflecting the severity of compression under 3D-RV reconstruction increased significantly. Also, significant differences were observed between the 3D-RV and 2-DSA groups concerning procedure time (10.56 ± 0.09 s vs. 12.59 ± 0.37 s; < 0.01), X-ray dose (41.25 ± 0.21 mGy vs. 81.59 ± 1.69 mGy; < 0.01) and contrast agent dosage (21.48 ± 0.24 mL vs. 33.69 ± 0.72 mL; < 0.01). Contralateral iliac vein imaging ( = 0.002), pelvic collateral vein imaging ( = 0.03), and external iliac vein indentation ( = 0.001) were found to influence the severity of iliac vein compression.
3D-RV can display dynamic stereo image information of NIVL, augmenting the information obtained from traditional 2-DSA. Contralateral iliac vein imaging, pelvic collateral vein imaging, and external iliac vein indentation can be used to evaluate the severity of iliac vein compression to some extent.
本研究的目的是确定与传统二维数字减影血管造影（2-DSA）相比，三维旋转静脉造影（3D-RV）在诊断非血栓性髂静脉病变中的技术可行性和安全性。
获取并分析了2018年10月至2022年10月期间通过3D-RV和传统2-DSA评估的61例非血栓性髂静脉病变（NIVL）患者的一般流行病学数据（包括年龄、性别）、临床表现（包括主要症状、患侧肢体、CEAP分级、合并症、狭窄率）以及术中发现（髂静脉压迹位置、侧支循环、手术时间、X线剂量、造影剂用量）。
本研究纳入了来自本机构的61例连续性有症状的NIVL患者。随着髂静脉狭窄程度的加重，3D-RV重建下反映压迫严重程度的对侧形成和髂静脉压迫压迹等指标的比例显著增加。此外，3D-RV组和2-DSA组在手术时间（10.56±0.09秒对12.59±0.37秒；<0.01）、X线剂量（41.25±0.21毫戈瑞对81.59±1.69毫戈瑞；<0.01）和造影剂用量（21.48±0.24毫升对33.69±0.72毫升；<0.01）方面存在显著差异。发现对侧髂静脉成像（=0.002）、盆腔侧支静脉成像（=0.03）和髂外静脉压迹（=0.001）会影响髂静脉压迫的严重程度。
3D-RV可以显示NIVL的动态立体图像信息，增加了从传统2-DSA获得的信息。对侧髂静脉成像、盆腔侧支静脉成像和髂外静脉压迹可在一定程度上用于评估髂静脉压迫的严重程度。
