Iliac Vein Compression Syndrome (IVCS): An Under-Recognized Risk Factor for Left-Sided Deep Venous Thrombosis (DVT) in Old Hip Fracture Patients

Liu, Junfeng; Liu, Pengcheng; Xia, Kuo; Chen, Liyang; Wu, Xing

doi:10.12659/msm.901639

Cited by 11 publications

(6 citation statements)

References 16 publications

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“…One-third of DVT patients develop PTS [ 5 ], resulting in significant impact on patient quality of life. Moreover, for populations susceptible to DVT, such as iliac vein compression syndrome (IVCS) in hip fracture patients, more aggressive measures are needed when DVT occurs [ 21 ]. Thus, timely and accurate diagnosis is important to implement active therapy and prevent the deterioration of DVT.…”

Section: Discussionmentioning

confidence: 99%

Combination of Circulating miRNA-320a/b and D-Dimer Improves Diagnostic Accuracy in Deep Vein Thrombosis Patients

Jiang

Wang

et al. 2018

Med Sci Monit

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BackgroundD-dimer tests have been widely used to rule-out deep venous thrombosis (DVT), but with low specificity. Circulating microRNAs (miRNAs) are novel promising biomarkers in diverse diseases. The purpose of our study was to identify the diagnostic abilities of circulating miRNA-320a/b and to assess their correlation with plasma D-dimer in DVT and post-thrombotic syndrome (PTS) patients.Material/MethodsPlasma samples were taken from 30 DVT patients, 30 PTS patients, and 30 age- and sex-matched healthy volunteers. Quantitative real-time PCR (qPCR) assay and turbidimetric immunoassay were conducted to assess the concentrations of miRNA-320a/b and D-dimer in plasma.ResultsCirculating miRNA-320a and miRNA-320b were significantly upregulated in DVT patients with fold changes of 1.58 and 1.79, respectively. The receiver operating characteristic (ROC) curve analysis showed area under the curve (AUC) values of 0.70 (95% CI: 0.56–0.83) for miRNA-320a and 0.79 (95% CI: 0.67–0.90) for miRNA-320b. Moreover, plasma levels of miRNA-320b were associated with D-dimer values (r=0.52, 95% CI: 0.19–0.74) in DVT. However, no significant changes in plasma miRNA-320a/b and D-dimer were detected in PTS patients.ConclusionsCompared with controls, circulating miRNA-320a/b was differentially expressed in DVT. Simultaneous detection of miRNA-320a/b with D-dimer may improve diagnostic accuracy of DVT.

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Section: Discussionmentioning

confidence: 99%

Combination of Circulating miRNA-320a/b and D-Dimer Improves Diagnostic Accuracy in Deep Vein Thrombosis Patients

Jiang

Wang

et al. 2018

Med Sci Monit

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“… 7) Recently, several studies recognized that MTS may be a risk factor for DVT after hip surgery. Liu et al 12) reported that left common iliac vein compression was significantly associated with DVT following hip fracture. Bergen et al 11) showed that left common iliac vein compression significantly increased the risk of DVT following THA.…”

Section: Discussionmentioning

confidence: 99%

“… 11) Recently, several studies suggested that MTS may be a risk factor for DVT after hip surgery. 11 12) However, the exact incidence of MTS among DVT patients who underwent THA is not known.…”

mentioning

confidence: 99%

Is the May-Thurner Syndrome a Major Risk Factor for Deep Vein Thrombosis in Total Hip Arthroplasty?

Lim,

Roh,

Kim

et al. 2024

Clin Orthop Surg

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Background May-Thurner syndrome (MTS) is iliac vein compression syndrome associated with postoperative deep vein thrombosis (DVT) resulting from chronic compression of the left iliac vein against lumbar vertebrae by the overlying right or left common iliac artery. MTS is not well known as a risk factor for DVT after total hip arthroplasty (THA). We evaluated the incidence of DVT after THA and analyzed if the MTS is a risk factor for DVT after THA. We hypothesized that MTS would be associated with an increased risk of developing DVT after THA. Methods All patients > 65 years of age who underwent THA between January 1, 2009, and January 12, 2017, were identified. Among them, the patients who presented for postoperative DVT of the lower extremity were reviewed with medical record data. MTS was diagnosed with computed tomography (CT) angiography of the lower extremity. We analyzed the demographic data, symptoms, diagnoses, and treatment of MTS patients. Results A total of 492 consecutive patients aged > 65 years who underwent operation for THA were enrolled. Among them, 5 patients (1.0%) presented for postoperative DVT of the lower extremity. After reviewing the CT angiography of the lower extremity, 4 out of 5 DVT patients (80%) were identified as having MTS. All MTS patients were female and presented with pain and swelling of the left leg. All MTS patients were treated with systemic anticoagulation, aspiration thrombectomy, and percutaneous transluminal angioplasty. Complete resolution of thrombus was observed in all patients. Conclusions If the diagnosis of MTS is delayed, the morbidity and mortality rates are significantly increased. Orthopedic surgeons should be aware of MTS as a risk factor for DVT after THA. Moreover, preoperative evaluation with duplex sonography or CT angiography to confirm MTS should be considered. In this regard, this study is considered to have sufficient clinical value for early diagnosis and appropriate treatment of MTS after THA.

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“…However, unilateral leg swelling and DVT, especially proximal lower extremity, caused by MTS in elderly patients was rarely diagnosed. A retrospective study of elderly patients with hip fractures, mean age of 81 years, showed that 34% of patients who developed DVT had baseline IVCS [ 4 ]. This resulted in an increased risk of DVT of up to 1.5- to two-fold.…”

Section: Discussionmentioning

confidence: 99%

May-Thurner Syndrome in an Elderly Man

Thangjui¹,

Trongtorsak²,

Zoltick³

et al. 2022

Cureus

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May-Thurner syndrome (MTS) is a rare cause of deep vein thrombosis (DVT). This diagnosis is seldomly included in the differential diagnosis. The disease is defined as extraluminal iliac vein compression by the arterial system against bony structures in the iliocaval area. This occurs more commonly on the left side due to the unfortunate position of the proximal left iliac vein that runs between the right common iliac artery and spine. MTS is commonly presented in younger female patients with left unilateral proximal DVT. However, MTS is rarely reported in elderly patients. We present a case of a 69-year-old man with a diagnosis of MTS and further management with a venous stent.

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Iliac Vein Compression Syndrome (IVCS): An Under-Recognized Risk Factor for Left-Sided Deep Venous Thrombosis (DVT) in Old Hip Fracture Patients

Cited by 11 publications

References 16 publications

Combination of Circulating miRNA-320a/b and D-Dimer Improves Diagnostic Accuracy in Deep Vein Thrombosis Patients

Combination of Circulating miRNA-320a/b and D-Dimer Improves Diagnostic Accuracy in Deep Vein Thrombosis Patients

Is the May-Thurner Syndrome a Major Risk Factor for Deep Vein Thrombosis in Total Hip Arthroplasty?

May-Thurner Syndrome in an Elderly Man

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