Clinical Study On The Diagnostic Performance Of Duplex Ultrasound In Detecting The Obstruction Of The Iliac Vein And The Patency Of Iliocaval Venous Stent

Part one Clinical Study on the Diagnostic Performance of Duplex Ultrasound in Detecting the Obstruction of the Iliac VeinObjective: To study the diagnostic performance of duplex ultrasound in detecting the obstruction of the iliac vein.Methods: The medical records of 444 patients admitted to the Department of Vascular Surgery at Affiliated Hospital of Jining Medical University with a diagnosis of saphenous varicose vein from November2021 to April 2022 were retrospectively collected.The sensitivity and specificity of duplex ultrasound for the diagnosis of iliac vein obstruction were investigated by comparing ultrasound and digital subtraction angiography(DSA)for the detection of iliac vein obstruction.Results: According to the inclusion and exclusion criteria,a total of249 patients with great saphenous vein varices were enrolled in this study.Ultrasound findings showed iliac vein obstruction in 14 patients(5.6%).According to DSA results,the degree of compression of the iliac veins was greater than 25% in 66 patients(26.5%)and greater than 50% in 25patients(10.1%).The sensitivity of ultrasound for the diagnosis of iliac vein obstruction was 12.0% and the specificity was 98.6% in all patients;in patients with greater than 25% iliac vein compression,the sensitivity of ultrasound for the diagnosis of iliac vein obstruction was 15.1% and the specificity was 100%;in patients with greater than 50% iliac vein compression,the sensitivity of ultrasound for the diagnosis of iliac vein obstruction was 20.0% and the specificity was 100%.Conclusion: In this study,the sensitivity of duplex ultrasonography for the diagnosis of iliac vein obstruction was poor,and DSA should be performed in patients with negative ultrasonography and high clinical suspicion of iliac vein obstruction.Part two Clinical Study on the Diagnostic Performance of Duplex Ultrasound in Detecting the Patency of Iliocaval Venous StentObjective: To study the diagnostic performance of duplex ultrasound in detecting the patency of iliocaval venous stent.Methods: The medical records of 157 patients who underwent iliac vein stent implantation in the Department of Vascular Surgery,Affiliated Hospital of Jining Medical University from August 2021 to February2023 were retrospectively collected.The sensitivity and specificity of duplex ultrasound in diagnosing iliac vein stent patency were investigated by comparing ultrasound and CT or DSA for the detection of iliac vein stent patency.Results: According to the inclusion and exclusion criteria,a total of121 patients with iliac vein stenting were included in this study.Among the categorical variables,no in-stent blood flow had a higher diagnostic efficiency in the diagnosis of iliac vein stent occlusion,with a sensitivity of 55.6%,a specificity of 100%,and an accuracy of 93.3%.Among the continuous variables,the stent/stent inlet flow velocity ratio had a higher diagnostic efficacy,with an average value of 1.07±0.61.The AUC for the diagnosis of iliac vein stent occlusion was 0.872,the sensitivity was80.0%,and the specificity was 98.1%.By comparing and analyzing the diagnostic efficacy of multiple ultrasound parameters,it was found that the diameter compression ratio of the iliac vein stent compression by the common iliac artery was greater than 50% combined with the blood flow velocity ratio at the entrance of the stent had the highest diagnostic efficacy.The AUC of the combined index in the diagnosis of iliac vein stent obstruction was 0.926,the sensitivity was 93.3%,and the specificity was 94.0%.Conclusion: In this study,the diagnostic efficacy of duplex ultrasound for iliac vein stent patency was high,and it was a useful tool for post-operative follow-up of iliac vein stents.