Early Clinical Efficacy Of Postoperative Nonthrombosis Iliac Vein Compression Syndrome

Objective:Assessment of severe left iliac vein stenosis after endovascular treatment and surgery of left varicose veins by CEAP/VCSS/CIVIQ-2,while observing the left iliac vein different patients with stenosis of early clinical efficacy of varicose veins surgery,explore the iliac vein compression syndrome without thrombosis (NIVCS) underwent endovascular treatment of varicose veins and the effect of early surgery for the treatment of non-iliac vein thrombosis provide a more reasonable comprehensive minimally invasive treatment options compression syndrome.Methods:Indexed April 2013-April 2015 in our hospital because of varicose veins left in the perioperative period in patients with left venous antegrade contrast also found iliac vein stenosis in patients with 129 cases. Follow before surgery whether endovascular treatment were divided into three groups:A:severe left iliac vein stenosis (greater than 70%) of 30 patients with left lower limb varicose vein surgery alone group. Group B:severe left iliac vein stenosis (greater than 70%) in 22 cases, first iliac vein balloon expandable stent implantation, again left varicose veins surgery. Group C:mild to moderate left iliac vein stenosis (20%-70%), with left lower limb varicose vein surgery alone group,67 cases. Detailed records of patient demographics, preoperative and postoperative use CEAP clinical grading and classification system VCSS clinical severity score and CIVIQ scale before in person or telephone follow-up surgery patients, each time after 3 months,6 months,12 months point score. One year after lower limb veins and iliac vein Doppler ultrasound review. Through the above evaluation criteria for different patients iliac vein stenosis were evaluated in each patient in each group significant difference in scale.Results:1. Compared with the preoperative, three groups of patients with simple varicose vein surgery or endovascular therapy plus varicose veins surgery after 3 months,6 months,12 months, severe CEAP clinical classification and VCSS clinical severity score and CIVIQ-2 QOL scores were significantly increased, the difference was statistically significant (P<0.05).2. The left iliac vein stenosis in patients with severe varicose vein surgery alone line group (A) and the left iliac vein severe stenosis underwent endovascular treatment of varicose veins left+ligation group (group B) after comparison:CEAP clinical classification in after 3 months,6 months and 12 months, patients in group B CEAP classification CO ratio were higher than group A, the difference was statistically significant (P<0.05); VCSS score after 3 months,6 months and 12 months, patients in group B than in group a reduced, the differences were statistically significant (P<0.05); CIVIQ-2 QOL scores after 3 months in group B than in group a reduced, the difference was statistically significant (P< 0.05), after 6 and 12 months CIVIQ-2 score in group B was significantly higher than the A group, the difference was statistically significant (P<0.05).3. With the left iliac vein stenosis in patients with mild to moderate varicose vein surgery with simple line group (group C) compared with severe left iliac vein stenosis underwent endovascular treatment of varicose veins left+ligation group (group B) after 3 months CIVIQ-2 QOL scores decreased, the remaining two groups of patients follow-up time point CEAP, VCSS, CIVIQ-2 score was no significant difference (P> 0.05).4. The left iliac vein stenosis in patients with severe varicose vein surgery alone line group (A) and patients with mild to moderate left iliac vein stenosis left varicose veins ligation group (group C) Comparison:CEAP clinical classification after 3 months,6 months and 12 months, patients in group C CEAP classification CO ratio were higher than group A, the difference was statistically significant (P<0.05); VCSS score after 3 months,6 months and 12 months, patients in group B A group than those in lower, the difference was statistically significant (P<0.05); CIVIQ-2 QOL score 3 months after the two groups showed no significant difference (P<0.05), after 6 and 12 months CIVIQ-2 score was significantly higher in group C than in group A, the difference was statistically significant (P<0.05).5. Color Doppler ultrasound one year after the review group B in the iliac vein was generally 100%, A group A group left varicose vein recurrence in 4 cases,1 case of group B, one case of group C.Conclusion:1, NIVCS iliac vein stenosis with mild to moderate temporarily without treatment, only need to solve the row varicose superficial vein reflux surgery, postoperative long-term wear elastic stockings to prevent recurrence. Term effect worthy of recognition, long-term and ultra-long-term effect needs further observation.2, severe iliac vein stenosis patients require endovascular therapy combined with surgical treatment of varicose veins, the exact effect, completely solve the causes of varicose veins, reduce the recurrence, is the ideal treatment of one NIVCS comprehensive minimally invasive treatment options the value of the promotion.3, femoral vein puncture segment iliac vein stenosis balloon dilatation joint NIVCS stenting is a safe and effective method of treatment, with a safe, effective and without serious complications.