Correlation Study Between Iliac Vein Compression Syndrome And Pulmonary Embolism In Patients With DVT

Objective: To study the relationship between the pulmonary embolism(PE)and the iliac vein compression syndrome(IVCS)in patients with acute deep venous thrombosis(DVT)of the lower extremity.Method: From June 2014 to December 2019,the medical records of 192 patients with acute lower extremity deep vein thrombosis diagnosed and treated in the vascular surgery of the Affiliated Hospital of Jining Medical College were reviewed.Using the imaging results of pulmonary artery CTA and iliac artery CTV,the percentage of iliac vein stenosis and CT pulmonary embolism index were measured and calculated,and the degree of iliac vein compression and pulmonary embolism were quantified respectively.The correlation between the relevant parameters and the degree of pulmonary embolism and pulmonary embolism was compared.Result: The average age of 192 DVT patients was 58.26 ± 13.03 years old,including 73 males and 119 females.There were 150 cases in IVCS group and42 cases in non IVCS group.There were significant differences in sex,DVT type,D-dimer abnormality,the percentage of iliac vein stenosis,pulmonary embolism and CT pulmonary embolism index between the two groups(P <0.05).Among them,51 males(34.0%)and 99 females(66.0%)were in the group with IVCS,22 males(52.4%)and 20 females(47.6%)were in the group without IVCS.The prevalence of DVT on the left and right sides of IVCSgroup were 149 cases(99.30%)of left lower extremity,0 case(0.00%)of right lower extremity,1 case(0.70%)of double lower extremity,27 cases(64.3%)of left lower extremity,13 cases(31.0%)of right lower extremity and 2 cases(4.80%)of double lower extremity.64 patients(42.7%)had pulmonary embolism in IVCS group and 29 patients(69.0%)had pulmonary embolism in non IVCS group.There was no significant difference between the two groups in the risk factors such as operation history,DVT complications such as varicosity and pulmonary embolism symptoms such as suffocation and chest distress(P > 0.05).The diameter of the right iliac vein in the same plane of the left iliac vein stenosis was significantly different in gender(P = 0.037).In the single factor analysis of exposure factors for pulmonary embolism,there were statistically significant differences in the history of heart,varicose vein,history of suffocation and chest distress,D-dimer abnormality,degree of IVCS and iliac vein compression(P < 0.05).Binary logistic regression analysis showed that IVCS was the influencing factor of pulmonary embolism in DVT patients,OR = 2.935(1.360-6.335),P = 0.006;the probability of pulmonary embolism decreased by 0.982 times(P = 0.016)for every 1% increase of iliac vein stenosis.The multiple linear regression analysis of CT pulmonary embolism index showed that iliac vein compression syndrome was the influencing factor of CT pulmonary embolism index(? =-4.399,P = 0.020);the percentage of iliac vein stenosis was negatively correlated with CT pulmonary embolism index(? =-0.110,P = 0.001).Conclusion: Women are more likely to develop iliac vein compression syndrome and secondary deep vein thrombosis of left lower extremity than men.The incidence of pulmonary embolism was low in DVT patients with iliac vein compression syndrome.The heavier the degree of iliac vein compression,the lower the degree of pulmonary embolism.The pulmonary embolism index of DVT patients without iliac vein compression is large,so we should pay attention to the prevention of pulmonary embolism.CTPA and CTV of iliac vein are very important for the diagnosis of pulmonary embolism and iliac vein compression syndrome.