Clinical therapeutic effect of left and right iliac vein compression syndrome after stenting: a single center retrospective study_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Wanhua , WANG Zhe ,  ZHAO Yu

Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P. R. China;

Corresponding?author：

ZHAO Yu, Email: 820994765@qq.com

Keywords：

non-thrombotic iliac vein compression syndrome; clinical symptoms; endovascular stent treatment; patency

DOI：

10.7507/1007-9424.202209090

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the improvement of clinical symptoms and patency of stents in patients with left and right non-thrombotic iliac vein compression syndrome (NIVCS) after endovascular stent therapy. Methods The clinical data of patients with NIVCS admitted to the First Affiliated Hospital of Chongqing Medical University from January 2016 to January 2021 were analyzed retrospectively. The venous clinical severity score of the patients’ veins before therapy and on month 12 after therapy was analyzed. At the same time, the patencies of stents on month 1, 3, 6, and 12 after stenting were also analyzed. Results A total of 164 patients with NIVCS were collected, including 144 left NIVCS and 20 right NIVCS. The surgical technique success rate of endovascular stent therapy was 100% (164/164). There was no statistical difference of the venous clinical severity score between the patients with left and right NIVCS on month 12 after therapy (t=1.265, P=0.208), but the venous clinical severity score of left and right NIVCS patients on month 12 after therapy were lower than those before therapy (t=27.534, P<0.001; t=10.047, P<0.001). The accumulative one-stage stent patency rate on month 12 after therapy was 96.5% and 94.7% in the patients with left and right NIVCS, respectively (χ²=0.160, P=0.689). After the stent was fully supported and completely covered the extent of the lesion, the short-term (within 12 months) stent patency rates of the patients with different compression site of the iliac vein, as well as type, diameter, and length of stent placement had no statistical differences (P>0.05). Conclusion From the results of this study, whether left NIVCS or right NIVCS, endovascular stent therapy is safe and effective.

Citation： LI Wanhua, WANG Zhe, ZHAO Yu. Clinical therapeutic effect of left and right iliac vein compression syndrome after stenting: a single center retrospective study. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(3): 327-332. doi: 10.7507/1007-9424.202209090 Copy

1.	Sheikh AB, Fudim M, Garg I, et al. The clinical problem of pelvic venous disorders. Interv Cardiol Clin, 2022, 11(3): 307-324.
2.	Gupta R, Mathijs E, Hart J, et al. May-Thurner syndrome and lymphedema reconstruction. Plast Reconstr Surg Glob Open, 2022, 10(6): e4377. doi: 10.1097/gox.0000000000004377.
3.	Poyyamoli S, Mehta P, Cherian M, et al. May-Thurner syndrome. Cardiovasc Diagn Ther, 2021, 11(5): 1104-1111.
4.	趙渝, 李德衛, 時德, 等. 髂靜脈受壓綜合征的解剖基礎. 中國實用外科雜志, 2003, 23(12): 745-746.
5.	Lugo-Fagundo C, Nance JW, Johnson PT, et al. May-Thurner syndrome: MDCT findings and clinical correlates. Abdom Radiol (NY), 2016, 41(10): 2026-2030.
6.	Yi JA, Hadley JB, Kuwayama DP. Atypical May-Thurner syndrome caused by endovascular aortic aneurysm repair. J Vasc Surg Cases Innov Tech, 2020, 6(3): 397-400.
7.	Fereydooni A, Stern JR. Contemporary treatment of May-Thurner syndrome. J Cardiovasc Surg (Torino), 2021, 62(5): 447-455.
8.	Liu XR, Zhou W, Chen F. Severe compression of left iliac vein is a protective factor for the risk of inferior vena cava thrombosis. J Vasc Surg Venous Lymphat Disord, 2022, 10(5): 1107-1112.
9.	李嘉穎, 孫志超, 許茂盛, 等. 多層螺旋CT多平面重建髂靜脈壓迫特征和分型的研究. 中華解剖與臨床雜志, 2020, 25(2): 109-115.
10.	Lou WS, Gu JP, He X, et al. Endovascular treatment for iliac vein compression syndrome: a comparison between the presence and absence of secondary thrombosis. Korean J Radiol, 2009, 10(2): 135-143.
11.	Shao C, Yan J, Zhang N, et al. Single-stage treatment with iliac vein stenting and stripping of the great saphenous vein for patients with left iliac vein compression syndrome. Asian J Surg, 2022, 45(1): 257-264.
12.	Costa LMG, Tachibana A, Magao FDS, et al. Magnetic resonance imaging evaluation of left common iliac vein compression in patients with and without symptoms of venous disease. Circ J, 2020, 84(5): 763-768.
13.	Endo M, Jahangiri Y, Horikawa M, et al. Antiplatelet therapy is associated with stent patency after iliocaval venous stenting. Cardiovasc Intervent Radiol, 2018, 41(11): 1691-1698.
14.	錢愛民, 蔡志新, 張實, 等. 腔內超聲輔助下非血栓性右髂靜脈受壓綜合征的血管腔內治療. 中華醫學雜志, 2019, 99(46): 3633-3637.
15.	中國醫師協會血管外科醫師分會靜脈學組. 常見靜脈疾病診治規范(2022年版). 中華血管外科雜志, 2022, 7(1): 12-29.
16.	Nyamekye IK. European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs. J Med Vasc, 2022, 47(2): 53-55.
17.	Poulose D, Deo K, Gogineni JM, et al. Correlation of venous clinical severity score with dermatology life quality index among patients with chronic venous insufficiency: a cross-sectional study. Cureus, 2021, 13(9): e17654. doi: 10.7759/cureus.17654.
18.	Nasif A, Ahmed AM, Al-Embideen S, et al. Unusual presentation of right-sided May-Thurner syndrome. J Vasc Surg Cases Innov Tech, 2021, 7(4): 768-771.
19.	Cheng L, Zhao H, Zhang FX. Iliac vein compression syndrome in an asymptomatic patient population: a prospective study. Chin Med J (Engl), 2017, 130(11): 1269-1275.
20.	李文東, 李曉強. 非血栓性髂靜脈受壓綜合征的爭議與共識. 中華普通外科雜志, 2016, 31(5): 436-438.
21.	Bækgaard N, Broholm R, Just S. Indications for stenting during thrombolysis. Phlebology, 2013, 28 Suppl 1: 112-116.
22.	Harbin MM, Lutsey PL. May-Thurner syndrome: history of understanding and need for defining population prevalence. J Thromb Haemost, 2020, 18(3): 534-542.
23.	Corrêa MP, Kurtz GS, Bianchini L, et al. Prevalence of left iliac vein compression on computed tomography scans from a population. J Vasc Bras, 2020, 19: e20190060. doi: 10.1590/1677-5449.190060.
24.	Roy M, Sasson M, Rosales-Velderrain A, et al. Pharmacomechanical thrombolysis for deep vein thrombosis in May-Thurner syndrome. Innovations (Phila), 2017, 12(6): 466-471.
25.	Jeon UB, Chung JW, Jae HJ, et al. May-Thurner syndrome complicated by acute iliofemoral vein thrombosis: helical CT venography for evaluation of long-term stent patency and changes in the iliac vein. AJR Am J Roentgenol, 2010, 195(3): 751-757.
26.	Raju S. Treatment of iliac-caval outflow obstruction. Semin Vasc Surg, 2015, 28(1): 47-53.
27.	Raju S, Knight A, Buck W, et al. Caliber-targeted reinterventional overdilation of iliac vein Wallstents. J Vasc Surg Venous Lymphat Disord, 2019, 7(2): 184-194.
28.	Razavi MK, Black S, Gagne P, et al. Pivotal study of endovenous stent placement for symptomatic iliofemoral venous obstruction. Circ Cardiovasc Interv, 2019, 12(12): e008268. doi: 10.1161/circinterventions.119.008268.
29.	黃家麒, 劉曉兵, 施慧華, 等. 不同解剖類型非血栓性髂靜脈壓迫綜合征支架植入術后的療效觀察. 中國血管外科雜志(電子版), 2019, 11(3): 195-198.
30.	Neglén P, Tackett TP, Raju S. Venous stenting across the inguinal ligament. J Vasc Surg, 2008, 48(5): 1255-1261.

1. Sheikh AB, Fudim M, Garg I, et al. The clinical problem of pelvic venous disorders. Interv Cardiol Clin, 2022, 11(3): 307-324.
2. Gupta R, Mathijs E, Hart J, et al. May-Thurner syndrome and lymphedema reconstruction. Plast Reconstr Surg Glob Open, 2022, 10(6): e4377. doi: 10.1097/gox.0000000000004377.
3. Poyyamoli S, Mehta P, Cherian M, et al. May-Thurner syndrome. Cardiovasc Diagn Ther, 2021, 11(5): 1104-1111.
4. 趙渝, 李德衛, 時德, 等. 髂靜脈受壓綜合征的解剖基礎. 中國實用外科雜志, 2003, 23(12): 745-746.
5. Lugo-Fagundo C, Nance JW, Johnson PT, et al. May-Thurner syndrome: MDCT findings and clinical correlates. Abdom Radiol (NY), 2016, 41(10): 2026-2030.
6. Yi JA, Hadley JB, Kuwayama DP. Atypical May-Thurner syndrome caused by endovascular aortic aneurysm repair. J Vasc Surg Cases Innov Tech, 2020, 6(3): 397-400.
7. Fereydooni A, Stern JR. Contemporary treatment of May-Thurner syndrome. J Cardiovasc Surg (Torino), 2021, 62(5): 447-455.
8. Liu XR, Zhou W, Chen F. Severe compression of left iliac vein is a protective factor for the risk of inferior vena cava thrombosis. J Vasc Surg Venous Lymphat Disord, 2022, 10(5): 1107-1112.
9. 李嘉穎, 孫志超, 許茂盛, 等. 多層螺旋CT多平面重建髂靜脈壓迫特征和分型的研究. 中華解剖與臨床雜志, 2020, 25(2): 109-115.
10. Lou WS, Gu JP, He X, et al. Endovascular treatment for iliac vein compression syndrome: a comparison between the presence and absence of secondary thrombosis. Korean J Radiol, 2009, 10(2): 135-143.
11. Shao C, Yan J, Zhang N, et al. Single-stage treatment with iliac vein stenting and stripping of the great saphenous vein for patients with left iliac vein compression syndrome. Asian J Surg, 2022, 45(1): 257-264.
12. Costa LMG, Tachibana A, Magao FDS, et al. Magnetic resonance imaging evaluation of left common iliac vein compression in patients with and without symptoms of venous disease. Circ J, 2020, 84(5): 763-768.
13. Endo M, Jahangiri Y, Horikawa M, et al. Antiplatelet therapy is associated with stent patency after iliocaval venous stenting. Cardiovasc Intervent Radiol, 2018, 41(11): 1691-1698.
14. 錢愛民, 蔡志新, 張實, 等. 腔內超聲輔助下非血栓性右髂靜脈受壓綜合征的血管腔內治療. 中華醫學雜志, 2019, 99(46): 3633-3637.
15. 中國醫師協會血管外科醫師分會靜脈學組. 常見靜脈疾病診治規范(2022年版). 中華血管外科雜志, 2022, 7(1): 12-29.
16. Nyamekye IK. European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs. J Med Vasc, 2022, 47(2): 53-55.
17. Poulose D, Deo K, Gogineni JM, et al. Correlation of venous clinical severity score with dermatology life quality index among patients with chronic venous insufficiency: a cross-sectional study. Cureus, 2021, 13(9): e17654. doi: 10.7759/cureus.17654.
18. Nasif A, Ahmed AM, Al-Embideen S, et al. Unusual presentation of right-sided May-Thurner syndrome. J Vasc Surg Cases Innov Tech, 2021, 7(4): 768-771.
19. Cheng L, Zhao H, Zhang FX. Iliac vein compression syndrome in an asymptomatic patient population: a prospective study. Chin Med J (Engl), 2017, 130(11): 1269-1275.
20. 李文東, 李曉強. 非血栓性髂靜脈受壓綜合征的爭議與共識. 中華普通外科雜志, 2016, 31(5): 436-438.
21. Bækgaard N, Broholm R, Just S. Indications for stenting during thrombolysis. Phlebology, 2013, 28 Suppl 1: 112-116.
22. Harbin MM, Lutsey PL. May-Thurner syndrome: history of understanding and need for defining population prevalence. J Thromb Haemost, 2020, 18(3): 534-542.
23. Corrêa MP, Kurtz GS, Bianchini L, et al. Prevalence of left iliac vein compression on computed tomography scans from a population. J Vasc Bras, 2020, 19: e20190060. doi: 10.1590/1677-5449.190060.
24. Roy M, Sasson M, Rosales-Velderrain A, et al. Pharmacomechanical thrombolysis for deep vein thrombosis in May-Thurner syndrome. Innovations (Phila), 2017, 12(6): 466-471.
25. Jeon UB, Chung JW, Jae HJ, et al. May-Thurner syndrome complicated by acute iliofemoral vein thrombosis: helical CT venography for evaluation of long-term stent patency and changes in the iliac vein. AJR Am J Roentgenol, 2010, 195(3): 751-757.
26. Raju S. Treatment of iliac-caval outflow obstruction. Semin Vasc Surg, 2015, 28(1): 47-53.
27. Raju S, Knight A, Buck W, et al. Caliber-targeted reinterventional overdilation of iliac vein Wallstents. J Vasc Surg Venous Lymphat Disord, 2019, 7(2): 184-194.
28. Razavi MK, Black S, Gagne P, et al. Pivotal study of endovenous stent placement for symptomatic iliofemoral venous obstruction. Circ Cardiovasc Interv, 2019, 12(12): e008268. doi: 10.1161/circinterventions.119.008268.
29. 黃家麒, 劉曉兵, 施慧華, 等. 不同解剖類型非血栓性髂靜脈壓迫綜合征支架植入術后的療效觀察. 中國血管外科雜志(電子版), 2019, 11(3): 195-198.
30. Neglén P, Tackett TP, Raju S. Venous stenting across the inguinal ligament. J Vasc Surg, 2008, 48(5): 1255-1261.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical therapeutic effect of left and right iliac vein compression syndrome after stenting: a single center retrospective study

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content