Evaluation of clinical and ultrasonographic prognostic factors for detection of iliac venous obstructions in patients with advanced chronic venous insufficiency

Abstract

Objective

This study evaluated clinical and ultrasonographic prognostic factors correlated with iliac venous obstructions (IVO) in patients with advanced chronic venous insufficiency (CVI).

Methods

Sixty-six patients with CVI were classified into Group I (CEAP C1-C2) or Group II (CEAP C3-C6) and categorized by IVO severity (<50%, 50%–79%, ≥80%). Factors analyzed included age, gender, ethnicity, body mass index (BMI), diabetes, deep vein thrombosis (DVT) history, limb laterality, and reflux in superficial, deep, and perforator venous systems. Multivariate logistic regression identified associations, with odds ratios (OR) calculated at a 95% confidence interval.

Results

Patients in both groups were predominantly female, white, and of similar age. Group I patients had higher BMI and lower abdominal circumference than Group II. Arterial hypertension was common in both groups, but deep vein thrombosis history was absent in Group I and present in 27.45% of Group II. Venous reflux was more frequent in Group II (74.5%) compared to Group I (36.7%). Regarding severity of IVO in Group II, 50% of limbs had <50% obstruction, 26.5% of limbs had 50%–79% obstruction, and 23.5% of limbs had ≥80% obstruction. Left limb was more frequently affected (70.58%) in significant obstructions found in Group II. Positive correlations were observed between IVO, non-recanalized DVT, and venous obstruction severity. Reflux in the deep venous system was a significant predictor for severe IVO in advanced chronic venous insufficiency patients (OR = 3.7, p = .02).

Conclusions

Deep venous reflux was shown to be a prognostic factor for detecting critical IVO in patients with advanced CVI. History of DVT, presence of reflux in the venous system of the lower limbs and non-recanalized DVT in advanced chronic venous insufficiency patients indicate the need for screening for IVO additional cross-sectional imaging.

Keywords

Iliac vein occlusion prognostic factors doppler venous ultrasound chronic venous insufficiency deep venous system reflux

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