Abstract：Objective This study aims to investigate the clinical efficacy and treatment characteristics of endovascular therapy in the treatment of left- and right-side iliac vein compression syndrome. Methods A retrospective cohort study was conducted. A total of 60 patients aged 29-74 (51.4±11.8) years, with non-thrombotic iliac vein compression syndrome (NIVCS), in the department of vascular surgery of the First Affiliated Hospital of Bengbu Medical College from June 2015 to June 2021 were included, including 29 males and 31 females. They were divided into two groups in accordance with the lesion side. Among them, 30 patients with left NIVCS were included in the L group, and 30 patients with right NIVCS were included in the R group. All patients received endovascular interventional therapy. The baseline data of the two groups were compared, and the improvement of their postoperative symptoms was observed. The perioperative indices, such as balloon diameter, balloon length, stent diameter, and stent length, of the two groups were also compared. The preoperative and 12-month postoperative venous clinical severity scores (VCSSs) were evaluated. Lower-limb deep-vein ultrasonography or anterograde venography was performed in patients with stent implantation at 6 and 12 months after surgery to observe the venous and stent blood flow, stent-related complications, and iliac vein patency rate. Results No significant difference was observed in the baseline data, such as gender, age, height, body mass, body mass index (BMI), and the clinical-etiology-anatomy-pathophysiology classification system grading of chronic venous diseases of the lower extremities, between the two groups (all P values>0.05). The operation of the two groups was successfully completed, of which 18 patients underwent simple balloon dilation, and 42 received balloon dilation combined with stent implantation. The postoperative follow-up time was 10-14 (12.7±0.9) months, and the clinical symptoms of all patients improved or completely returned to normal. One patient in the L group had lower-extremity deep-vein thrombosis on the 12th month after surgery. No significant difference was found in in balloon length, stent diameter, and preoperative and 1 h postoperative iliac vein stenosis rates between the two groups (all P values>0.05). The iliac vein stenosis rate of the L and the R groups at 1 h after operation (4.0[3.0, 6.0] and 4.5[3.0,6.0]) was significantly lower than that before operation (95.0[89.8,98.0] and 95.0[90.0,96.0]), and the differences within the group were statistically significant (Z=-4.79、-4.79, all P values<0.001). The balloon diameter of the L group was higher than that of the R group [(13.4±1.5) mm vs. (12.3±1.4) mm], and the length of stent was less than that of the R group [(60.0±8.9) mm vs. (79.1±13.4) mm], with statistically significant differences (t=2.85,-5.423, all P values<0.05). The preoperative VCSSs of the L group 12.5 (11.0, 13.3) was higher than the 12th month postoperative VCSSs 4.0 (3.0, 5.0), and the preoperative VCSSs of the R group 12.0 (11.0, 13.0) was higher than the 12th month postoperative VCSSs 4.0 (3.0, 5.0), and the difference were statistically significant (Z=-4.80, -4.81, all P values<0.001). The preoperative and 12th month postoperative VCSSs of the two groups were not statistically significant (Z=-0.85, 0.12, all P values>0.05). The patency rate of iliac vein stent was 100% (42/42) at 6 months and 97.61% (41/42) at 1 year. No other serious complications, such as stent displacement and detachment, were observed during follow-up in all patients. Conclusion For the treatment of left- and right-side NIVCS, endovascular therapy has good short- and medium-term efficacy and safety. However, the diameter of the stent selected for the treatment of left-sided NIVCS is smaller than the diameter of the balloon, and the diameter of the stent selected for the treatment of right-sided NIVCS is larger than the diameter of the balloon. Compared to the right NIVCS, the left side NIVCS was treated with a larger balloon diameter and a smaller stent length.
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2023, Vol. 28 
