Correlation Study Between Left Iliac Vein Compression And Left Lower Extremity Deep Vein Thrombosis

Objective:To evaluate the left common iliac vein(LCIV) minor diameter and stenosis with computer tomography(CT)of left lower extremity deep vein thrombosis(DVT) patients, right lower extremity DVT patients and normal population, and explore the correlation between LCIV compression and left lower extremity DVT. Methods:A retrospective analysis the clinical characteritics and related risk factors, aslo analysis the records and CT imaging, measurement and calculation of LCIV and RCIV minor diameter and then calculated LCIV stenosis were conducted in 19 right-sided DVT, 60 left-sided DVT and 218 control group. Multiple factors regression analysis was used to study the correlation of LCIV minor diameter and stenosis with left-sided DVT. Results:LCIV diameter of women [(4.70±2.69)mm] was significantly smaller than that of men [(6.60±3.29)mm,p<0.01)]. In control subjects, 51.8% had greater than 50% compression of LCIV, and 24.3% had greater than 70% compression.LCIV diameter in group left-sided DVT [(2.39±0.98)mm] was significantly smaller than that in group control [(49.31±25.34)mm,p<0.01)] or group sight-sided DVT [(38.01±21.38)mm,P<0.01)]. LCIV stenosis in group left-sided DVT [(77.57 ±8.28)%] was higher than that in group control [(49.31±25.34)%,p<0.001)] or group sight-sided DVT [(38.01±21.38)%,p<0.01)].The odds of left DVT increased by a factor of 2.06(p<0.001,95%CI=1.63-2.60) for each millimeter decrease in LCIV diameter(adjusted OR=2.69,p<0.001; 95%CI=1.91-3.77), and relative risk of 2.34(p <0.001 95% CI =1.79-3.06)for each ten percent increase in LCIV stenosis(p<0.001,95%CI=1.95-3.96)(adjusted OR = 2.78, p <0.001,95% CI = 1.95-3.96). With LCIV diameter <2.5mm population associated relative risk of occurrence of the left lower limb DVT is LCIV diameter> 2.5mm 8.41 fold increase(adjusted OR = 13.57, P <0.001; 95% CI, 5.58 ~ 32.99). Relative risk With LCIV stenosis rate> 75% of the population associated relative risk of occurrence of the left lower limb DVT is LCIV stenosis <75% of 8.18 fold increase(adjusted OR=11.1,95% CI = 4.93 ~ 22.02). Conclusion:LCIV compression was a normal anatomic pattern, rather than a kind of pathological anatomy variation. LCIV minor diameter and stenosis were independent risk factors for the development of left-sided DVT, and LCIV compression might be an anatomical premise or foundation of the development of left DVT. The patients with severe LCIV compression and exposure to other prothrombotic risk factors were the high risk group of left-sided DVT, and should get more emphasis on left DVT prophylaxis. Severe left iliac vein stenosis(LCIV <2.5mm, or LCIV stenosis rate> 75%) are at high risk of DVT in the left leg, should be more active and efficient prevention of its occurrence of DVT. CT evaluation has important significance for prevention and treatment of left iliac vein compression on DVT.