Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, 49 North Huayuan Road, Haidian District, 100191, Beijing, China.
Sci Rep. 2024 Aug 13;14(1):18837. doi: 10.1038/s41598-024-69598-8.
Nonthrombotic iliac vein lesions (NIVLs) are significant causes of chronic venous insufficiency (CVI) in the left lower limb and symptom recurrence following left lower limb varicose vein treatment. The goal of this study was to explore the haemodynamic and morphological characteristics of iliac veins in patients with NIVLs. Pressure at the caudal end of the stenotic left common iliac vein (LCIV) segment, local blood flow velocity, and time-averaged wall shear stress in the stenotic segment exhibited positive correlations with the clinical CVI classification (R = 0.92, p < 0.001; R = 0.94, p < 0.001; R = 0.87, p < 0.001), while the relative retention time showed a negative correlation (R = -0.94, p < 0.001). The pressure difference (∆P) between the two ends of the stenotic segment and the velocity difference (∆V) between the stenotic segment and the caudal end were positively correlated with the clinical classification (R = 0.92, p < 0.001; R = 0.9, p < 0.001). The cross-sectional area stenosis rate and length of the stenotic LCIV segment were positively correlated with the clinical classification (R = 0.93, p < 0.001; R = 0.63, p < 0.001). The results suggest that haemodynamic assessment of the iliac vein could effectively portray blood flow disturbances in stenotic segments of the LCIV, potentially reflecting the degree of iliac vein stenosis. Haemodynamic indicators are correlated with the severity of clinical CVI symptoms.
非血栓性髂静脉病变(NIVLs)是左下肢慢性静脉功能不全(CVI)和左下肢静脉曲张治疗后症状复发的重要原因。本研究旨在探讨 NIVLs 患者髂静脉的血流动力学和形态学特征。狭窄段左髂总静脉(LCIV)尾端压力、局部血流速度和狭窄段平均壁切应力与临床 CVI 分级呈正相关(R=0.92,p<0.001;R=0.94,p<0.001;R=0.87,p<0.001),而相对滞留时间呈负相关(R=-0.94,p<0.001)。狭窄段两端的压力差(ΔP)和狭窄段与尾端的速度差(ΔV)与临床分级呈正相关(R=0.92,p<0.001;R=0.9,p<0.001)。狭窄段 LCIV 的横截面积狭窄率和长度与临床分级呈正相关(R=0.93,p<0.001;R=0.63,p<0.001)。结果表明,髂静脉血流动力学评估可有效描绘 LCIV 狭窄段的血流紊乱,可能反映髂静脉狭窄程度。血流动力学指标与临床 CVI 症状的严重程度相关。