Common iliac vein stenosis and risk of symptomatic pulmonary embolism: an inverse correlation.

Abstract

PURPOSE To test the hypothesis that a common iliac vein (CIV) stenosis may impair embolization of a large deep venous thrombosis (DVT) to the lungs, decreasing the incidence of a symptomatic pulmonary embolism (PE). MATERIALS AND METHODS Between January 2002 and August 2007, 75 patients diagnosed with unilateral DVT were included in a single-institution case-control study. Minimum CIV diameters were measured 1 cm below the inferior vena cava (IVC) bifurcation on computed tomography (CT) images. A significant stenosis in the CIV ipsilateral to the DVT was defined as having either a diameter 4 mm or less or a greater than 70% reduction in lumen diameter. A symptomatic PE was defined as having symptoms and imaging findings consistent with a PE. The odds of symptomatic PE versus CIV stenosis were assessed using logistic regression models. The associations between thrombus location, stenosis, and symptomatic PE were assessed using a stratified analysis. RESULTS Of 75 subjects, 49 (65%) presented with symptomatic PE. There were 17 (23%) subjects with a venous lumen 4 mm or less and 12 (16%) subjects with a greater than 70% stenosis. CIV stenosis of 4 mm or less resulted in a decreased odds of a symptomatic PE compared with a lumen greater than 4 mm (odds ratio [OR] 0.17, P = .011), whereas a greater than 70% stenosis increased the odds of DVT involving the CIV (OR 7.1, P = .047). CONCLUSIONS Among patients with unilateral DVT, those with an ipsilateral CIV lumen of 4 mm or less have an 83% lower risk of developing symptomatic PE compared with patients with a CIV lumen greater than 4 mm.

DOI: 10.1016/j.jvir.2010.10.009
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@article{Chan2011CommonIV, title={Common iliac vein stenosis and risk of symptomatic pulmonary embolism: an inverse correlation.}, author={Keith T Chan and Rita A Popat and Daniel Y. Sze and W. T. Kuo and Nishita Kothary and John D. Louie and David M. Hovsepian and Gloria L. Hwang and Lawrence Vincent Hofmann}, journal={Journal of vascular and interventional radiology : JVIR}, year={2011}, volume={22 2}, pages={133-41} }