Computed tomography venography versus intravascular ultrasound in the diagnosis of iliofemoral vein stenosis

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 38-44
Author(s):  
Ming Ren Toh ◽  
Karthikeyan Damodharan ◽  
Han Hui Mervin Nathan Lim ◽  
Tjun Yip Tang
Keyword(s):  
Computed Tomography ◽  
Diagnostic Performance ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Diagnostic Tools ◽  
Venous Disease ◽  
Significant Stenosis ◽  
Vein Segment ◽  
Vein Stenosis ◽  
Computed Tomography Venography

Summary: Background: Iliofemoral vein stenosis can cause debilitating chronic venous disease. Diagnostic tools include both computed tomography venography (CTV) and intravascular ultrasonography (IVUS). We aim to compare the diagnostic performance of CTV and IVUS. Patients and methods: We performed a retrospective study of patients with chronic venous disease presenting with iliac vein compression or post-thrombotic limb symptoms, excluding those with acute deep vein thrombosis, high anaesthesia risk, or who had contrast allergy. All patients received CTV before IVUS, as part of the diagnostic work-up and intervention. The cross-sectional area (CSA) of iliofemoral vein segments obtained from both studies were compared against reference CSAs to derive percentage stenosis. A 50% reduction in CSA was considered significant. Results: We studied 50 patients between May 2018 and April 2019. 58% of patients had severe disease CEAP C5-6. 48% of patients had at least one vein segment with significant stenosis. The left proximal common iliac vein was the most commonly stenosed vein segment (n = 12, 24% on IVUS). CSA measurements from CTV were greater than those of IVUS, with a correlation coefficient of 0.57 (p < 0.005). Conversely, percentage stenosis measured on CTV was lower than on IVUS, with approximately one-third of significant stenosis missed on CTV (58 veins from CTV vs. 78 from IVUS, p < 0.005). With IVUS as the gold standard, CTV has low sensitivity (37.2%, 95% CI 26.5–48.9) and high specificity (92.5%, 95% CI 89.3–94.9) in detecting significant stenosis. Conclusions: CTV has limited diagnostic performance in identifying iliofemoral vein stenosis. Patients with normal CTV findings should proceed with IVUS imaging if the clinical features are supportive of iliofemoral vein stenosis.

Popliteal venous aneurysms and iliac vein compression: a possible association

2013 ◽  
Vol 29 (6) ◽  
pp. 386-389 ◽  
Author(s):  
Ahmed S Gaweesh ◽  
Mohamed H Kayed ◽  
Tamer Y Gaweesh ◽  
Aly Shata
Keyword(s):  
Computed Tomography ◽  
Incidental Finding ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Aneurysm ◽  
Venous Disease ◽  
Contrast Injection ◽  
Duplex Scan ◽  
Iliac Vein Compression ◽  
Computed Tomography Venography

Popliteal venous aneurysms have always been linked to death from pulmonary embolism. Incidental finding of an asymptomatic popliteal venous aneurysm during duplex scan performed for patients with chronic venous disease is increasingly diagnosed but the relation between popliteal venous aneurysms and chronic venous disease remains unknown. We report the incidental finding of three asymptomatic popliteal venous aneurysms associated with iliac vein compression in patients with chronic venous disease who had undergone computed tomography venography with direct pedal contrast injection. An association between popliteal venous aneurysms and iliac vein compression is postulated.

scholarly journals Diosmin Alleviates Venous Injury and Muscle Damage in a Mouse Model of Iliac Vein Stenosis

2022 ◽  
Vol 8 ◽  
Author(s):  
Zhiye Guo ◽  
Xiaolong Du ◽  
Yihua Zhang ◽  
Chunwan Su ◽  
Feng Ran ◽  
...  
Keyword(s):  
Mouse Model ◽  
Therapeutic Effect ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Sequencing Analysis ◽  
Venous Injury ◽  
Venous Diseases ◽  
Vein Stenosis ◽  
Dose Dependent

Chronic venous disease (CVD) is a progressive inflammatory disease that increases in prevalence with age. Elucidating the underlying molecular mechanism of CVD development is essential for disease prevention and treatment. This study constructed a mouse model of iliac vein stenosis to explore the mechanism of the CVD disease progression, and diosmin was administered as a positive control (as recommended by clinical practice). The mouse model was established successfully with iliac vein stenosis, leading to the expansion of the intercellular space and venous leakage. Conversely, micronized diosmin showed a dose-dependent therapeutic effect for these manifestations. Concerning the mechanism, iliac vein stenosis caused an inflammatory response in veins, while diosmin suppressed this increase. Furthermore, RNA sequencing analysis indicated that diosmin significantly improved muscle function through actin filament organization and muscle contraction. These results indicated that the mouse model of iliac vein stenosis is a reliable model to study venous diseases. Furthermore, the dose-dependent therapeutic effect of diosmin on stenosis (without toxic side-effects) suggests greater protection against venous diseases at higher doses of diosmin.

Optimal sizing of iliac vein stents

2017 ◽  
Vol 33 (7) ◽  
pp. 451-457 ◽  
Author(s):  
Seshadri Raju ◽  
William J Buck ◽  
William Crim ◽  
Arjun Jayaraj
Keyword(s):  
Therapeutic Option ◽  
Femoral Vein ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Initial Procedure ◽  
The Common ◽  
The Right ◽  
Vein Stenosis ◽  
Scaling Rule

Background Iliac vein stenting has emerged as a therapeutic option in chronic venous disease. The optimal stent size is unknown but should match normal caliber at a minimum. Methods Teleology: The iliac-femoral outflow caliber was measured by Duplex in healthy volunteers to determine normal caliber. Patient IVUS data: The distribution curve of IVUS planimetry data in 345 chronic venous disease limbs was analyzed: values at the right tail end of the curve should approach normal values according to distribution theory. The optimal stent size was also projected using Poiseuille equation and Young’s scaling rule. Results The optimal stent sizes in the common iliac, external iliac, and common femoral vein segments are: 16, 14, and 12 mm diameters, respectively. Conclusion Stent correction of iliac vein stenosis should aim to restore the lumen to the minimum recommended caliber during the initial procedure and later re-interventions.

Endovenous stenting in chronic venous disease secondary to iliac vein obstruction

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
Mohamed A. Taha ◽  
Tristan Lane ◽  
Joseph Shalhoub ◽  
Alun H. Davies
Keyword(s):  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease

scholarly journals A Systematic Review of Endovenous Stenting in Chronic Venous Disease Secondary to Iliac Vein Obstruction

2016 ◽  
Vol 63 (2) ◽  
pp. 555-556 ◽  
Author(s):  
M.J. Seager ◽  
A. Busuttil ◽  
B. Dharmarajah ◽  
A.H. Davies
Keyword(s):  
Systematic Review ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease

Diagnostic Performance of Standard and Inverted Grey-Scale CXR in Detection of Lung Lesions in COVID-19 Patients: A Single Institute Study in the Region of Abu Dhabi

2021 ◽  
Vol 02 ◽  
Author(s):  
Abeer A. Al Helali ◽  
Mohamed A. Kukkady ◽  
Ghufran A. Saeed ◽  
Tamer I. Elholiby ◽  
Rabab A. Al Mansoori ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Performance ◽  
Tertiary Care ◽  
Chest Radiographs ◽  
Diagnostic Tools ◽  
Lung Lesions ◽  
Healthcare Facilities ◽  
Grey Scale ◽  
Ct Findings ◽  
Significant Difference

Purpose: This study aimed at evaluating the diagnostic performance of standard greyscale and inverted greyscale Chest X-ray (CXR) using Computed Tomography (CT) scan as a gold standard. Methods: In this retrospective study, electronic medical records of 120 patients who had valid CXR and High-resolution CT (HRCT) within less than 24 hours after having a positive COVID-19 RT-PCR test during the period from May 19th to May 23rd, 2020, in a single tertiary care center were reviewed. PA chest radiographs were presented on 2 occasions to 5 radiologists to evaluate the role and appropriateness of standard greyscale and inverted greyscale chest radiographs (CXR) when images are viewed on high-specification viewing systems using a primary display monitor and compared to computed tomography (CT) findings for screening and management of suspected or confirmed COVID-19 patients. Results: Ninety-six (80%) patients had positive CT findings, 81 (67.5%) had positive grey scale CXR lesions, and 25 (20.8%) had better detection in the inverted grey scale CXR. The CXR sensitivity for COVID-19 pneumonia was 93.8% (95% CI (86.2% - 98.0%) and the specificity was 48.7% (95% CI (32.4% - 65.2%). The CXR sensitivity of detecting lung lesions was slightly higher in male (95.1% (95% CI (86.3% - 99.0%)) than female (90.0% (95% CI (68.3% - 98.8%)), while the specificity was 48.0% (95% CI (27.8% - 68.7%) and 50.0% (95% CI (23.0% - 77.0%) in males and females, respectively. However, no significant difference was detected in ROC area between men and women. Conclusion: The sensitivity of detecting lung lesions of CXR was relatively high, particularly in men. The results of the study support the idea of considering conventional radiographs as an important diagnostic tool in suspected COVID-19 patients, especially in healthcare facilities where there is no access to HRCT scans. CXR shows high sensitivity for detecting lung lesions in HRCT confirmed COVID-19 patients. Better detection of lesions was noted in the inverted greyscale CXR in 20.8% of cases, with positive findings in standard greyscale CXR. Conventional radiographs can be used as diagnostic tools in suspected COVID-19 patients, especially in healthcare facilities where there is no access to HRCT scans.

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