Efficacy Analysis Of Endovascular Therapy For Nonthrombotic Iliac Vein Compression Syndrome With Mild Varicose Veins

Objective:To compare the clinical effect of endovascular therapy and physical therapy for nonthrombotic iliac vein compression syndrome(NIVCS)with mild varicose veins.To understand whether early intervention of NIVCS can alleviate or curb the progress of the varicose veins of the lower extremities,and provide reference for clinical treatment.Methods:Retrospective analysis of clinical data of 30 patients with NIVCS with mild varicose veins in the Fourth Affiliated Hospital of Kunming Medical University from Oct 2017 to Apr 2019.The patients were divided into two groups according to the different treatment methods.Group A(15 patients)underwent left iliac vein balloon dilatation and stent implantation,and after surgery were treated with anticoagulation and antiplatelet therapy.Group B(15 patients)underwent physical treatment after NIVCS diagnosis was confirmed.Compared whether there were statistical differences in rVCSS,CIVIQ-14,iliac vein thrombosis,the regurgitation time of saphenous-femoral vein valve during follow-up.Results:Group A successfully underwent balloon dilatation and stent implantation(17stents in total,2 patients were implanted with 2 stents).After endovascular treatment,review of venography revealed that the collateral vessels were significantly reduced or disappeared than before.Venography and CTV were performed at 1,3,6 and 12 months after operation,and there was no restenosis or occlusion of iliac vein stent,and the patency rate of iliac vein stent was 100%.In group B,the deep vein was unobstructed and there was no iliac vein thrombosis during follow-up.After treatment,the rVCSS of group A and group B were lower than before(P<0.05).The postoperative rVCSS of group A was lower than that of group B at each follow-up time point(P<0.05).After treatment,the CIVIQ-14 scores of both groups A and B were higher than before(P<0.05).The CIVIQ-14 score of A and B in the first month after surgery were not statistically significant(P>0.05),but the scores of group A were higher than group B at 3,6,and 12 months after treatment(P<0.05).During the follow-up period,the regurgitation time of saphenous-femoral vein valve in group A was shorter than before(P<0.05).At 1 and 3 months after treatment,there was no significant difference in the regurgitation time of saphenous-femoral vein valve in group B compared with before(P>0.05).But at 6 and 12 months after treatment,the regurgitation time of saphenous-femoral vein valve in group B was longer than before(P<0.05).Conclusion:Endovascular therapy for NIVCS with mild varicose veins has a positive effect during the 12-month follow-up.The iliac vein stent was unobstructed and there was no stent thrombosis.Endovascular therapy not only preserved the great saphenous vein,but also alleviated the symptoms of varicose veins of the lower extremities,and delayed the progress of varicose veins of the lower extremities.The curative effect is obviously better than physical therapy,but the long-term curative effect still needs further observation.