| Objective In this paper.we analyze the hemodynamic changes of the compressed vein under pressure by means of color Doppler ultrasonography,and preliminarily explore the changing regularity of iliac vein compression syndrome.which provide the basic theoretical basis for the diagnosis.treatment and prevention of iliac vein compression syndrome,as well as the theoretical study of its pathogenesis.Methods According to the inclusion and exclusion criteria,39 patients with CVI were retrospectively analyzed frJiangsu om January 2018 to December 2018 in the vascular surgery department of the Northern People’s Hospital.All patients were examined by CTV and color Doppler ultrasonography,and the compression degree of left iliac vein was calculated according to CTV exam,and was divided into three groups according to A,B.and C.There were 13 cases in group A(stenosis degree<50%),14 cases in group B(compression degree 50-70%)and 12 cases in group C(compression degree>70%).The general data,clinical symptoms,CTV and color Doppler ultrasound measurements of patients with different degrees of compression were analyzed.Results There were 39 patients enrolled,including 20 males and 19 females with an average age of 59.46±10.30 years.According to CEAP classification criteria,the number of patients in grade C 4 was 30,followed by grade C 5 and grade C 6,which were 4 cases respectively.CTV exam showed that the mean stenosis degree was 54.62±18.85%and the angle between inferior vena cava and left iliac vein was 136.44±14.70 degrees.The mean diameter of stenosis measured by ultrasound was 4.24±1.45 mm.which was significantly smaller than that of distal stenosis 7.75 ±2.32 mm(P<0.05)and proximal stenosis 8.03±2.10 mm(P<0.05).Meanwhile.the shear rate at the stenosis was 620.76±330.75 s-1.which was significantly higher than that at distal stenosis(269.36±131.26 s-1)and proximal stenosis(276.8 ±130.86 s-1).and the difference was statistically significant(P<0.05).Statistical analysis of patients with different degrees of compression showed that gender had no effect on the degree of compression(P=0.825):there was no significant difference in the proportion of CEAP grades among different degrees of stenosis(P=0.563).In addition,there were no significant differences in systolic blood pressure(P=0.825),BMI(P=0.476),complication(P=0.751)and the angle between inferior vena cava and left iliac vein(P=0.449)among patients with different degrees of stenosis.It was also found that there was a significant difference in collateral circulation ratio between patients with different compression degrees(P=0.039),further analysis showed the ratio of collateral circulation in group C was significantly higher than that in group A and B(P<0.05).For the hemodynamic analysis of patients with different degrees of compression,the difference in internal diameter(P<0.001)and shear rate(P=0.001)between the different degrees of stenosis was statistically significant.Further analysis showed that the diameter of stenosis in group C(3.26±0.89mm)was significantly lower than that in group A(5.58 ±1.49mm)and group B(3.83 ±0.75mm),while the shear rate in group C(839.42±336.51 s-1).There was no significant difference between group A(381.78±111.89 s-1)and group B(655.25±331,46 s-1).Although the inner diameter of the stenosis in group B was smaller than that in group A.the shear rate was higher than that in group A,the difference was not statistically significant.There was no significant difference in the diameter.blood flow velocity and shear rate between the proximal and distal ends of stenosis in different groups(P>0.05)Conclusion We can measure the blood flow velocity and the inner diameter of iliac vein by color Doppler ultrasonography,which is reliable,simple and repeatable.This experiment suggests that the shear rate will increase significantly when the degree of left iliac vein stenosis exceeds 50%.The higher shear rate increases the chance of damage to the intima and is the pathophysiological basis for inducing deep vein thrombosis and lower extremity venous insufficiency.Therefore,the progress of this study will provide a theoretical basis for further study on the hemodynamic changes of iliac vein compression in the future,and explore the feasibility of prevention and treatment of lower extremity venous diseases. |
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