Reduced External Iliac Venous Blood Flow Rate Is Associated with Asymptomatic Compression of the Common Iliac Veins.

Yuan-Hsi Tseng,Chien-Wei Chen,Teng-Yao Yang,Bor-Shyh Lin,Yu-Hui Lin,Min-Yi Wong,Yao-Kuang Huang

doi:10.3390/medicina57080835

Abstract

Background and Objectives: Compression of the common iliac veins (CIV) is not always associated with lower extremity symptoms. This study analyzed this issue from the perspective of patient venous blood flow changes using quantitative flow magnetic resonance imaging. Materials and Methods: After we excluded patients with active deep vein thrombosis, the mean flux (MF) and mean velocity (MV) of the popliteal vein, femoral vein, and external iliac vein (EIV) were compared between the left and right sides. Results: Overall, 26 of the patients had unilateral CIV compression, of which 16 patients had symptoms. No significant differences were noted in the MF or MV of the veins between the two sides. However, for the 10 patients without symptoms, the EIV MF of the compression side was significantly lower than the EIV MF of the non-compression side (p = 0.04). The receiver operating characteristic curve and chi-squared analyses showed that when the percentage difference of EIV MF between the compression and non-compression sides was ≤−18.5%, the relative risk of associated lower extremity symptoms was 0.44 (p = 0.016). Conclusions: If a person has compression of the CIV, a decrease in EIV blood flow rate on the compression side reduces the rate of symptom occurrence.

Highlights

Compression of the right, left, or bilateral common iliac vein (CIV) or the inferior vena cava (IVC) by a right common iliac artery or tortuous aorta, which includes May–Thurner syndrome (MTS), can cause venous outflow tract stenosis or occlusion
This study analyzed the data of 61 patients who underwent TRANCE MRI with QFlow acquisition for suspected lower extremity symptoms related to venous disease between October 2018 and July 2020
The median age was 62 years, and the majority of rose sequentially from the popliteal vein (PV) to femoral vein (FV) and external iliac vein (EIV), which was consistent with the normal the patients were female (76.5%)

Summary

Introduction

Thurner syndrome (MTS), can cause venous outflow tract stenosis or occlusion This can result in symptoms related to lower extremity venous hypertension or insufficiency, such as pain, leg heaviness, edema, skin change, venous ulcer, or deep vein thrombosis (DVT) [1,2,3]. The fact that some patients do not have symptoms or have delayed onset of symptoms has previously been explained from an anatomical perspective, including differences in the severity of iliac vein compression or the development of intimal hyperplasia. Compression of the common iliac veins (CIV) is not always associated with lower extremity symptoms. This study analyzed this issue from the perspective of patient venous blood flow changes using quantitative flow magnetic resonance imaging.

Methods

Results

Discussion

Conclusion