A comparative study of altered hemodynamics in iliac vein compression syndrome

被引:1
|
作者
Assi, Ismael Z. [1 ]
Lynch, Sabrina R. [1 ]
Ricker, Brian D. [2 ]
Ranjane, Siddhant V. [1 ]
Williams, David M. [3 ]
Wakefield, Thomas W. [4 ]
Obi, Andrea T. [4 ]
Figueroa, C. Alberto [1 ,4 ]
机构
[1] Univ Michigan, Dept Biomed Engn, Ann Arbor, MI 48109 USA
[2] Johns Hopkins Univ, Sch Arts & Sci, Baltimore, MD USA
[3] Univ Michigan, Dept Radiol, Div Vasc & Intervent Radiol, Ann Arbor, MI USA
[4] Univ Michigan, Dept Surg, Sect Vasc Surg, Ann Arbor, MI USA
关键词
iliac vein compression syndrome; May-Thurner syndrome; Cockett syndrome; computational fluid dynamics; thrombosis; shear rate; patient-specific modeling; DIAGNOSIS;
D O I
10.3389/fbioe.2024.1302063
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
Introduction: Iliac vein compression syndrome (IVCS) is present in over 20% of the population and is associated with left leg pain, swelling, and thrombosis. IVCS symptoms are thought to be induced by altered pelvic hemodynamics, however, there currently exists a knowledge gap on the hemodynamic differences between IVCS and healthy patients. To elucidate those differences, we carried out a patient-specific, computational modeling comparative study.Methods: Computed tomography and ultrasound velocity and area data were used to build and validate computational models for a cohort of IVCS (N = 4, Subject group) and control (N = 4, Control group) patients. Flow, cross-sectional area, and shear rate were compared between the right common iliac vein (RCIV) and left common iliac vein (LCIV) for each group and between the Subject and Control groups for the same vessel.Results: For the IVCS patients, LCIV mean shear rate was higher than RCIV mean shear rate (550 +/- 103 s-1 vs. 113 +/- 48 s-1, p = 0.0009). Furthermore, LCIV mean shear rate was higher in the Subject group than in the Control group (550 +/- 103 s-1 vs. 75 +/- 37 s-1, p = 0.0001). Lastly, the LCIV/RCIV shear rate ratio was 4.6 times greater in the Subject group than in the Control group (6.56 +/- 0.9 vs. 1.43 +/- 0.6, p = 0.00008).Discussion: Our analyses revealed that IVCS patients have elevated shear rates which may explain a higher thrombosis risk and suggest that their thrombus initiation process may share aspects of arterial thrombosis. We have identified hemodynamic metrics that revealed profound differences between IVCS patients and Controls, and between RCIV and LCIV in the IVCS patients. Based on these metrics, we propose that non-invasive measurement of shear rate may aid with stratification of patients with moderate compression in which treatment is highly variable. More investigation is needed to assess the prognostic value of shear rate and shear rate ratio as clinical metrics and to understand the mechanisms of thrombus formation in IVCS patients.
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页数:12
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