Diagnostic Analysis Of Non-thrombotic Iliac Vebous Compression Lesion With Varicose Veins By Anterograde Venography

Purpose: To assess the percentage of patients with varicose veins with non-thrombotic iliac vein compression lesion in varicose veins of the lower extremity.To explore the efficacy and feasibility of venography in the diagnosis of non-thrombotic iliac vein compression with varicose veins.Methods: A retrospective analysis was performed on 1333 patients with lower extremity varicose admitted to our hospital between January 2014 and February 2018,and the clinical data of 478 patients with anterograde venography was included.These patients were divided into three groups according to the degree of left iliac vein stenosis.Group I,stenosis ?50%;group II,30% < stenosis < 50%;and group III,stenosis < 30%.The correlation among gender,age,symptoms,courses,deep venous reflux,incompetent perforating veins,cryptorectal valve insufficiency of lower extremities was analyzed between the three groups.The correlation factors of clinical symptom severity were analyzed.Results: There were 125 patients with NIVCL,accounting for 26.15%,among which 68 cases had stenosis degree 50%,accounting for 14.23%.141(29.50%)patients with deep venous reflux and 21(4.39%)patients with incompetent perforating veins.Patients with deep venous reflux included 2 cases of congenital absence of valves and 11 cases of deep vein regurgitation grade III.Between three groups,there was no difference in course(p=0.542),deep vein reflux(p=0.177),incompetent perforating veins(p=0.579).In the group I,the incidence of great saphenous vein valve insufficiency in varicosities patients combined with IVCS was 66.18%.Age was negatively correlated with the presence of IVCS(OR,0.997;95% CI 0.958~0.997;p =0.023).There was difference between symptoms and gender,age.Women had more severe symptoms than men(OR,0.679;95% CI,0.489-0.944;p=0.021).CEAP classification was positively correlated with age(OR,1.025;95% CI,1.009-1.043;p=0.003).Conclusion: The incidence of NIVCL is high in varicose patients.The anterograde venography was of high clinical significance in diagnosis and treatment of varicose veins which can reveal the normal anatomy,abnormal structure such as iliac vein stenosis,venous lesion and valve insufficiency.The proportion of patients with lower extremity varicose veins combined with NIVCL was higher.Venography can accurately reflect the anatomical structure of the deep and superficial veins,and provide reliable basis for the diagnosis of non-thrombotic iliac vein compression in patients with varicose veins and the selection of correct surgical methods,so as to reduce postoperative complications.