Effect of stent treatment on hemodynamics in iliac vein compression syndrome with collateral vein

Li, Chaoqun; Zhan, Yanqing; Wang, Zhongming; Gao, Yongxin; Ye, Kaichuang; Lu, Xinwu; Qiu, Ping; Yang, Cheng

doi:10.1016/j.medengphy.2023.103983

Cited by 2 publications

(1 citation statement)

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“…Ultrasound studies have demonstrated that anatomical compression of the LCIV increases post-stenotic blood velocities by as much as 3-8x (Labropoulos et al, 2007;Oğuzkurt et al, 2007;Cheng et al, 2017;Engelhorn et al, 2021). Computational fluid dynamics studies have further demonstrated that IVCS leads to increased blood velocities, wall shear stresses, and pressure gradients in the stenosed vessel (Wang et al, 2022;Assi et al, 2023;Li et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

A comparative study of altered hemodynamics in iliac vein compression syndrome

Assi,

Lynch,

Ricker

et al. 2024

Front. Bioeng. Biotechnol.

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Introduction: Iliac vein compression syndrome (IVCS) is present in over 20% of the population and is associated with left leg pain, swelling, and thrombosis. IVCS symptoms are thought to be induced by altered pelvic hemodynamics, however, there currently exists a knowledge gap on the hemodynamic differences between IVCS and healthy patients. To elucidate those differences, we carried out a patient-specific, computational modeling comparative study.Methods: Computed tomography and ultrasound velocity and area data were used to build and validate computational models for a cohort of IVCS (N = 4, Subject group) and control (N = 4, Control group) patients. Flow, cross-sectional area, and shear rate were compared between the right common iliac vein (RCIV) and left common iliac vein (LCIV) for each group and between the Subject and Control groups for the same vessel.Results: For the IVCS patients, LCIV mean shear rate was higher than RCIV mean shear rate (550 ± 103 s−1 vs. 113 ± 48 s−1, p = 0.0009). Furthermore, LCIV mean shear rate was higher in the Subject group than in the Control group (550 ± 103 s−1 vs. 75 ± 37 s−1, p = 0.0001). Lastly, the LCIV/RCIV shear rate ratio was 4.6 times greater in the Subject group than in the Control group (6.56 ± 0.9 vs. 1.43 ± 0.6, p = 0.00008).Discussion: Our analyses revealed that IVCS patients have elevated shear rates which may explain a higher thrombosis risk and suggest that their thrombus initiation process may share aspects of arterial thrombosis. We have identified hemodynamic metrics that revealed profound differences between IVCS patients and Controls, and between RCIV and LCIV in the IVCS patients. Based on these metrics, we propose that non-invasive measurement of shear rate may aid with stratification of patients with moderate compression in which treatment is highly variable. More investigation is needed to assess the prognostic value of shear rate and shear rate ratio as clinical metrics and to understand the mechanisms of thrombus formation in IVCS patients.

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