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Abstract No. 232: Iliac Vein Stenosis and Thrombus Volume: A Positive Correlation in Lower Extremity Deep Venous Thrombosis

2009; Elsevier BV; Volume: 20; Issue: 2 Linguagem: Inglês

10.1016/j.jvir.2008.12.225

1535-7732

Keith Chan, Daniel Y. Sze, William T. Kuo, Nishita Kothary, John D. Louie, David M. Hovsepian, Gloria L. Hwang, Lawrence V. Hofmann,

Venous Thromboembolism Diagnosis and Management

PurposeStenosis of the iliac veins is commonly seen on cross-sectional imaging of patients with deep venous thrombosis (DVT). We hypothesize that a venous stenosis impairs blood flow out of the extremity and predisposes the extremity to a larger and more proximal thrombus burden, compared to those vessels without a stenosis.Materials & MethodsAn IRB approved, single institution, retrospective review of the radiology information system was conducted using ICD-9 codes to identify all cases of unilateral lower-extremity DVT from 2002 to 2007. Cross-sectional minor axis diameter measurements were performed of the iliac veins 1cm below the IVC bifurcation on CT venograms. The percent stenosis was calculated by dividing the symptomatic limb iliac vein diameter by the contralateral asymptomatic limb iliac vein diameter. Additionally, the thrombus volume was calculated using a semi-automated 3D reconstruction of 5mm-thick CT slices. The locations of the thrombosed venous segments were also recorded.ResultsSixty-two patients were identified with unilateral lower limb DVT without pulmonary embolism or IVC involvement. Only those with CT venograms taken at time of presentation were included. Eleven patients, with a mean age of 53 years (range 27 to 86 years), were assessed. Six (55%) patients were male, and 8 (73%) had left-sided DVT. The average iliac vein stenosis was 36% ± 33% (mean ± 1SD; range 0 to 89%). For left-sided DVT, involvement of the common femoral or external iliac vein was observed in 75% (n=4) of cases with >50% stenosis, but in none of those with <50% stenosis. The average thrombus burden was calculated to be 7,017 ± 5,733 mm 3 (mean ± 1SD, range 1,044 to 20,343 mm 3). A positive correlation of thrombus burden to percent stenosis was observed (r = 0.63, p 50% stenosis, but in none of those with <50% stenosis. The average thrombus burden was calculated to be 7,017 ± 5,733 mm 3 (mean ± 1SD, range 1,044 to 20,343 mm 3). A positive correlation of thrombus burden to percent stenosis was observed (r = 0.63, p 50% stenosis, but in none of those with <50% stenosis. The average thrombus burden was calculated to be 7,017 ± 5,733 mm 3 (mean ± 1SD, range 1,044 to 20,343 mm 3). A positive correlation of thrombus burden to percent stenosis was observed (r = 0.63, p<0.05). ConclusionIn DVT patients, venous stenosis appears to correlate with volume of thrombus burden as well as central large vein involvement. In DVT patients, venous stenosis appears to correlate with volume of thrombus burden as well as central large vein involvement.