Analysis On The Effect And Influencing Factors Of Endovascular Treatment Of Different Clinical Types Of Iliac Vein Compression Syndrome

Objective:To investigate the difference of medium and long-term efficacy,the degree of improvement of quality of life and related influencing factors in patients with different clinical strains of iliac vein compression syndrome treated intracranially,so as to provide some evidence-based basis for clinical treatment.Methods:The case data of 90 patients admitted to our hospital from September2016 to September 2021 who met the diagnosis of iliac vein compression syndrome(IVCS)were retrospectively analyzed,and all patients were treated with percutaneous transluminal angioplasty(PTA)combined with stent implantation in our department with a complete follow-up of at least 12 months after surgery.The patients were divided into 46 patients with non-thrombotic iliac vein compression syndrome(NIVCS)and 44 patients with thrombotic iliac vein compression syndrome(TIVCS)according to clinical typing.stent type,stent diameter,total stent length,stent position,first postoperative color ultrasound Doppler examination,postoperative anticoagulation regimen,and the venous clinicalseverity score(VCSS)was applied to assess the efficacy of the procedure,and the chronic venous insufficiency quality of life questionnaire(CIVIQ)was used.The quality of life questionnaire(CIVIQ-20)was used to evaluate the preoperative and postoperative quality of life of the patients,and the improvement of clinical symptoms,complications and stent patency rate assessed at the postoperative follow-up ultrasound 12 months after surgery were counted,and then the patients were divided into patency and restenosis groups according to whether the stents were restenosed or not for univariate analysis.The single factors with significant differences between groups were compared,and the independent risk factors leading to postoperative stent restenosis were screened by binary logistic regression analysis,and the diagnostic efficacy of the model was evaluated by applying ROC curves.Results:All patients had 100% success rate of surgery,and the first postoperative review of lower limb venous Doppler ultrasound showed that the implanted stent was vascularized and there was no intra-stent thrombosis.At least 12 months of postoperative follow-up,the stent patency rate was82.22% in all patients,including 91.30% in the NIVCS group and 72.72% in the TIVCS group,and the VCSS score decreased from 10.18±4.40 to 3.87±2.64 in all patients,from 10.54±4.05 to 3.67±2.91,VCSS in TIVCS patients from 9.80±4.75 to 4.07±2.33,CIVIQ-20 in all patients from 54.26±6.13 to 28.37±6.82,CIVIQ-20 in NIVCS patients from 53.17±5.44 to27.83 ± 7.78,and TIVCS patients Univariate analysis showed that thrombotic IVCS,BMI,history of hypertension,multiple stent placement,and postoperative anticoagulation regimen were significantly associated with the occurrence of stent restenosis(P<0.05),and multifactorial logistic regression analysis showed that thrombotic IVCS(OR=7.099,95%CI=1.332~37.839,P=0.022),BMI(OR=1.340,95% CI=1.078~1.667,P=0.009),and history of hypertension(OR=5.994,95% CI=1.304~27.548,P=0.021)were risk factors for postoperative stent restenosis.factor.the area under the curve of ROC prediction model was 0.866,(95% CI: 0.726~1.000,P=0.000),the sensitivity was 87.5.3%,the specificity was 83.8%,the accuracy of the model to evaluate stent restenosis was high,the area under the curve of BMI was 0.743,(95% CI: 0.613~0.873,P=0.000),the with a sensitivity of 68.8%and specificity of 71.6%;the area under the IVCS type curve was 0.659,(95% CI: 0.516~0.801,P=0.000),with a sensitivity of 75.0% and specificity of 56.8%;the area under the hypertension history curve was 0.649,(95% CI:0.490~0.807,P=0.000),with a sensitivity of 50.0% and specificity of 79.7%.Conclusions:Both patients with NIVCS and TIVCS treated endovenously showed great improvement in clinical symptoms and quality of life at 1 year after surgery,and both had high mid-and long-term stent patency rates and fewer complications,but the mid-and long-term stent patency rates were higher and the complication rates were lower in the NIVCS group than in the TIVCS group.Thrombotic IVCS,obesity,and hypertensive disease are independent risk factors for postoperative stent restenosis.Early interventions are needed to reduce the incidence of thrombotic IVCS in the NIVCS group,to enhance the follow-up of patients in the TIVCS group,and postoperative weight and blood pressure control is important to reduce the incidence of stent restenosis.