The association between vascular risk factors and the occurrence of non-thrombotic iliac vein lesions in patients with chronic venous disorders
, 1
Abstract
Introduction: Recently non-thrombotic iliac vein lesions (NIVL) due to their possible role in chronic venous
insufficiency on one side and to the development of endovascular venous techniques on the other side have
gained much interest. The purpose of this study was to establish if vascular risk and anthropometric factors are
associated with the occurrence of NIVL in patients with chronic venous disorders.
Material and methods: Thirty-three patients (8 men and 25 women) of the median age of 48 years with
primary varicose veins that were qualified for great saphenous veins high ligation and stripping were included.
The data concerning age, sex, body mass, height, body mass index, body surface area, hypertension, hypercholesterolemia,
smoking and diabetes have been collected. During the varicose vein surgery, both iliac venous
axis were interrogated with intravascular ultrasound. Percentage of stenosis of interrogated veins was calculated.
The association between analyzed factors and morphology of iliac veins was statistically determined.
Results: In a univariate analysis age negatively correlated with left common iliac vein (LCIV) stenosis and
male sex, greater weight and body surface area and hypertension were associated with lesser stenosis of left
external iliac vein. In a multivariate analysis, only age significantly negatively correlated with LCIV stenosis
(p = 0.027). There was a correlation of borderline statistical significance between female sex and LCIV stenosis
(p = 0.073). No other correlations were observed.
Conclusions: Except for age and possibly sex, there is no association between NIVL and other anthropometric
and vascular risk factors.
Keywords: intravascular ultrasoundnon-thrombotic iliac vein lesionsprimary varicose veins
References
- May R, Thurner J. The Cause of the Predominantly Sinistral Occurrence of Thrombosis of the Pelvic Veins. Angiology. 2016; 8(5): 419–427.
- Virchow R. Uber die Erweiterung kleiner Gefasse. Arch Path Anat. 1851; 3: 427.
- MCMURRICH J. The occurrence of congenital adhesions in the common iliac veins and their relation to the thrombosis of the femoral and iliac veins. Am J Med Sci. 1908; 135(3): 342–345.
- Carpentier PH, Maricq HR, Biro C, et al. Prevalence, risk factors, and clinical patterns of chronic venous disorders of lower limbs: a population-based study in France. J Vasc Surg. 2004; 40(4): 650–659.
- Sisto T, Reunanen A, Laurikka J, et al. Prevalence and risk factors of varicose veins in lower extremities: mini-Finland health survey. Eur J Surg. 1995; 161(6): 405–414.
- Lee AJ, Robertson LA, Boghossian SM, et al. Prevalence of venous reflux in the general population on duplex scanning: the Edinburgh vein study. J Vasc Surg. 1998; 28(5): 767–776.
- Eklöf Bo, Rutherford R, Bergan J, et al. Revision of the CEAP classification for chronic venous disorders: Consensus statement. Journal of Vascular Surgery. 2004; 40(6): 1248–1252.
- Dzieciuchowicz Ł, Krzyżański R, Kruszyna Ł, et al. Prevalence of non-thrombotic iliac vein lesions in patients with unilateral primary varicose veins. Eur J Vasc Endovasc Surg. 2016; 51(3): 429–433.
- Hingorani A, Alhabouni S, Ascher E, et al. Role of IVUS versus venograms in assessment of iliac-femoral vein stenosis. Journal of Vascular Surgery. 2010; 52(3): 804.
- Neglén P, Raju S. Intravascular ultrasound scan evaluation of the obstructed vein. J Vasc Surg. 2002; 35(4): 694–700.
- Montminy M, Thomasson J, Tanaka G, et al. A comparison between intravascular ultrasound and venography in identifying key parameters essential for iliac vein stenting. Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2019; 7(6): 801–807.
- Gagne PJ, Tahara RW, Fastabend CP, et al. Venography versus intravascular ultrasound for diagnosing and treating iliofemoral vein obstruction. J Vasc Surg Venous Lymphat Disord. 2017; 5(5): 678–687.
- Kibbe MR, Ujiki M, Goodwin AL, et al. Iliac vein compression in an asymptomatic patient population. J Vasc Surg. 2004; 39(5): 937–943.
- Moreland NC, Ujiki M, Matsumura JS, et al. Decreased incidence of left common iliac vein compression in patients with abdominal aortic aneurysms. J Vasc Surg. 2006; 44(3): 595–600.
- Dreischarf M, Albiol L, Rohlmann A, et al. Age-related loss of lumbar spinal lordosis and mobility--a study of 323 asymptomatic volunteers. PLoS One. 2014; 9(12): e116186.
- Pries E, Dreischarf M, Bashkuev M, et al. The effects of age and gender on the lumbopelvic rhythm in the sagittal plane in 309 subjects. J Biomech. 2015; 48(12): 3080–3087.
- Raju S, Neglen P. High prevalence of nonthrombotic iliac vein lesions in chronic venous disease: a permissive role in pathogenicity. J Vasc Surg. 2006; 44(1): 136–43; discussion 144.
- Arshad R, Pan F, Reitmaier S, et al. Effect of age and sex on lumbar lordosis and the range of motion. A systematic review and meta-analysis. J Biomech. 2019; 82: 1–19.
- Leven D, Merrill R, Kim J, et al. Fundamental differences and changes in pelvic parameters depending on age, gender and race. The Spine Journal. 2016; 16(10): S277.