Criteria for detecting significant chronic iliac venous obstructions with duplex ultrasound

Metzger, Patrick Bastos; Rossi, Fábio Henrique; Kambara, Antônio Massamitsu; Izukawa, Nilo Mitsuru; Saleh, Mohamed Hassan; Pinto, Ibraim Masciarelli Francisco; Amorim, Jorge Eduardo de; Thorpe, Patricia E.

doi:10.1016/j.jvsv.2015.07.002

Cited by 68 publications

(59 citation statements)

References 23 publications

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“…No iliofemoral venous thrombosis but abnormal venous flow was found in 21% of the patients [12] in abnormal venous flow states, venous blood refluxes or backward down the veins into an already congested leg [8]. This is related to blockage by tumor external compression in our study.…”

Section: Discussionmentioning

confidence: 56%

“…CT scan in the study traced along from their femoral vein, external iliac vein, common iliac vein and inferior vena cava, and from vascular patency to obliteration by their tumor to detect the compression site. A duplex ultrasound was also done during the presence of a unilateral lower-extremity swelling to detect femoral venous thrombosis or venous flow insufficiency [6, 7, 8]. The only exclusion criterion was the presence of bilateral lower-extremity swelling because of the probability of an inferior vena cava lesion.…”

Section: Methodsmentioning

confidence: 99%

“…The only exclusion criterion was the presence of bilateral lower-extremity swelling because of the probability of an inferior vena cava lesion. Abnormal venous flow was defined as a condition where venous flow reflux or venous flow insufficiency without the presence of thrombosis occurred [8]. …”

Section: Methodsmentioning

confidence: 99%

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Iliofemoral Venous Thrombosis Mainly Related to Iliofemoral Venous Obstruction by External Tumor Compression in Cancer Patients

et al. 2016

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Background: To study iliofemoral venous thrombosis related to iliofemoral venous obstruction in cancer patients. Methods: In this case series study, 829 cancer patients were surveyed for iliofemoral obstruction/thrombosis within 10 years. The criteria for inclusion were: (1) presence of unilateral lower-extremity swelling; (2) computed tomography (CT) scans showing a tumor with external compression of the iliac or femoral vein, and (3) duplex ultrasound scans showing venous thrombosis or venous flow insufficiency over a femoral vein or saphenous vein. Results: Sixty-three patients (8%) developed an iliofemoral venous obstruction. The presence of iliofemoral venous thrombosis was detected in 21 of these patients (33%). The rate of iliofemoral venous thrombosis was significantly higher in patients with an invasion of the inguinal region, D-dimer levels >3,000 ng/ml, gastrointestinal cancer, or invasion of the inguinal lymph nodes. However, none of our patients with iliofemoral venous thrombosis had a detection of iliofemoral venous obstruction. Improved lower-extremity swelling was reported in 84% of the patients following combination therapy involving low-molecular-weight heparin (LMWH) and systemic therapy. Conclusion: Patients with an iliofemoral venous thrombosis mainly had iliofemoral venous obstruction by external tumor compression. Combination therapy with LMWH and systemic therapy were mandatory for these patients.

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Section: Discussionmentioning

confidence: 56%

Section: Methodsmentioning

confidence: 99%

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Iliofemoral Venous Thrombosis Mainly Related to Iliofemoral Venous Obstruction by External Tumor Compression in Cancer Patients

et al. 2016

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“…In these situations an examination of the iliac tract and the inferior vena cava is mandatory. In a recently published study, using IVUS as a gold standard, a velocity ratio of > 2.5 was the best criterion for the detection of signifi cant venous obstruction in the iliac veins [51]. Subsequently, the deep femoral vein, femoral vein, and popliteal vein should be analysed every few centimetres in a B-mode cross-section for compressibility and post-thrombotic changes.…”

Section: State Of the Deep Venous Systemmentioning

confidence: 99%

Clinical and duplex ultrasound evaluation of lower extremities varicose veins – a practical guideline

Spinedi

Brož

Engelberger

et al. 2017

Vasa

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Summary:Lower extremities varicose veins are among the most frequent diseases in the general population. They can cause complaints with a deterioration of the quality of life and are associated with potentially threatening clinical conditions such as chronic venous ulceration, haemorrhage from ruptured varicose veins, and venous thromboembolism. An accurate diagnostic work-up is crucial to confi rm the presence and the extension of the venous problem, in order to obtain an optimal management of the condition. In the past years, great efforts have been made to reach an international consensus on the terminology, the symptomatology, the classifi cation, and the duplex ultrasound examination of lower extremities varicose veins. Mainly guided by these consensus documents, the present article describes the diagnostic work-up of lower extremities varicose veins, based on a careful medical history, physical examination, and duplex ultrasound examination.

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“…Participants were asked to answer a comprehensive questionnaire based on signs and symptoms regarding venous disease in the lower limbs and history of previous DVT. 10,11 We divided patients into 2 groups: group Asymptomatic, composed of the participants who did not mention any symptoms in the lower limbs, and group Symptomatic, composed of those who answered yes to at least one positive sign or symptom in the questionnaire for the left leg.…”

mentioning

confidence: 99%

Magnetic Resonance Imaging Evaluation of Left Common Iliac Vein Compression in Patients With and Without Symptoms of Venous Disease

Costa

Tachibana

Magao

et al. 2020

Circ J

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Background: The goal of this study was to assess the degree of the left common iliac vein (LCIV) compression by the right common iliac artery (RCIA) on magnetic resonance imaging (MRI), and verify differences in compression measurements in end-inspiration, end-expiration, supine, and prone decubitus between patients with and without symptoms in the lower limbs. Methods and Results: A total of 82 consecutive participants provided informed consent and underwent pelvic MRI for different clinical indications other than vascular-related disorders. The participants answered a questionnaire about venous disease in the lower limbs and history of previous deep vein thrombosis. This study measured the area and diameter of the LCIV at the site of the crossing with the RCIA and in the uncompressed caudal LCIV segment. Statistical analysis was performed to compare the degree of LCIV compression by the RCIA and verify differences in compression measurements. A total of 71 participants were included; 46.6% were in group A and did not experience signs and symptoms in lower limbs and 53.6% were in group B and answered at least one question with a positive answer. It was observed that there was a statistically significant difference between groups for end-expiration. No statistically significant differences were observed for all other measurements. Conclusions: A substantial percentage of the asymptomatic and symptomatic population showed compression of the LCIV, suggesting there are no clear relationships between stenosis and non-specific symptomatology in the general population.

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Criteria for detecting significant chronic iliac venous obstructions with duplex ultrasound

Cited by 68 publications

References 23 publications

Iliofemoral Venous Thrombosis Mainly Related to Iliofemoral Venous Obstruction by External Tumor Compression in Cancer Patients

Iliofemoral Venous Thrombosis Mainly Related to Iliofemoral Venous Obstruction by External Tumor Compression in Cancer Patients

Clinical and duplex ultrasound evaluation of lower extremities varicose veins – a practical guideline

Magnetic Resonance Imaging Evaluation of Left Common Iliac Vein Compression in Patients With and Without Symptoms of Venous Disease

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