Criteria for detecting significant chronic iliac venous obstructions with duplex ultrasound

Objective The purpose of this study was to determine the sonographic criteria for diagnosis of iliac venous outflow obstruction by assessing the correlation of this method with intravascular ultrasound (IVUS) in patients with advanced chronic venous insufficiency (CVI). Methods The evaluation includ...

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Bibliographic Details
Published in:Journal of vascular surgery. Venous and lymphatic disorders (New York, NY) NY), 2016-01, Vol.4 (1), p.18-27
Main Authors: Metzger, Patrick Bastos, MD, Rossi, Fabio Henrique, MD, PhD, Kambara, Antônio Massamitsu, MD, PhD, Izukawa, Nilo Mitsuru, MD, PhD, Saleh, Mohamed Hassan, MD, PhD, Pinto, Ibraim M.F., MD, PhD, Amorim, Jorge Eduardo, MD, PhD, Thorpe, Patricia E., MD, FSIR
Format: Article
Language:English
Subjects:
Adult
Chronic Disease
Extremities
Female
Humans
Iliac Vein - diagnostic imaging
Male
Middle Aged
Surgery
Ultrasonography, Doppler, Duplex
Vascular Diseases
Veins
Venous Insufficiency - diagnostic imaging
Venous Pressure
Venous Thrombosis
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Summary:Objective The purpose of this study was to determine the sonographic criteria for diagnosis of iliac venous outflow obstruction by assessing the correlation of this method with intravascular ultrasound (IVUS) in patients with advanced chronic venous insufficiency (CVI). Methods The evaluation included 15 patients (30 limbs; age, 49.4 ± 10.7 years; 1 man) with initial CVI symptoms (Clinical class, Etiology, Anatomy, and Pathophysiology [CEAP] classification, CEAP1-2 ) in group I (GI) and 51 patients (102 limbs; age, 50.53 ± 14.5 years; 6 men) with advanced CVI symptoms (CEAP3-6 ) in group II (GII). Patients from both groups were matched by gender, age, and race. The Venous Clinical Severity Score was considered. All patients underwent structured interviews and duplex ultrasound (DU) examination, measuring the flow phasicity, the femoral volume flows and velocities, and the velocity and obstruction ratios in the iliac vein. The reflux multisegment score was analyzed in both groups. Three independent observers evaluated individuals in GI. GII patients were submitted to IVUS, in which the area of the impaired venous segments was obtained and compared with the DU results and then grouped into three categories: obstructions 
ISSN:2213-333X
2213-3348
DOI:10.1016/j.jvsv.2015.07.002