Comparative assessment of left common iliac vein compression in patients with hypermobile Ehlers-Danlos syndrome,hypermobility spectrum disorder and healthy controls – A retrospective single-centre study
Restricted accessResearch articleFirst published online July, 2026
Comparative assessment of left common iliac vein compression in patients with hypermobile Ehlers-Danlos syndrome,hypermobility spectrum disorder and healthy controls – A retrospective single-centre study
Heritable connective tissue disorders (HCTDs), including hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobile spectrum disorder (HSD), have complex clinical manifestations, but the prevalence of left common iliac vein (LCIV) compression in these groups is not well known. This study aimed to compare the prevalence of significant LCIV compression in patients with hEDS, HSD, and healthy controls.
Methods
This retrospective, IRB-approved, single-center study analyzed 109 patients (25 hEDS, 64 HSD, 20 controls) who underwent contrast-enhanced abdominal and pelvic CT imaging from 2020 to 2023. LCIV compression was measured on axial CT, with >50% luminal narrowing defined as significant. Statistical analyses included chi-square tests, odds ratios, and t-tests. Interrater reliability was evaluated using intraclass correlation coefficients.
Results
Significant LCIV compression occurred in 68.0% of hEDS, 65.6% of HSD, and 35.0% of controls (p = 0.034). Both hEDS (p = 0.027) and HSD (p = 0.015) groups had significantly higher compression rates than controls, with no statistically significant difference between the two clinical groups (p = 0.831). Odds of compression were nearly fourfold greater in hEDS (OR 3.95) and HSD (OR 3.54) compared to controls.
Conclusion
LCIV compression is significantly more prevalent in patients with hEDS and HSD than in healthy controls, warranting further investigation of its clinical significance.
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