Impact of anatomical features of non-thrombotic left iliac venous compression on the development of venous leg ulcers based on CT venography

Purpose

To explore the anatomical features of left iliac vein (LIV) in non-thrombotic venous leg ulcers (VLUs) and to identify the impact of these anatomical features on VLUs based on computed tomography venography (CTV).

Methods

This is a retrospective, single-center study of a database (2021–2023) of 431 patients with non-thrombotic chronic venous insufficiency. According to CEAP clinical (C) classifications, cases of C6 and C2 were included for analysis as case and control groups. Based on CTV data, variables that reflected the anatomical characteristics of LIV and lower lumbar degenerative changes were compared between the two groups. Multivariate logistic regression analysis was performed to evaluate impact of the anatomical features of LIV on VLUs.

Results

A total of 116 patients (group C6 (n = 33) and C2 (n = 83)) were included. Variables including anterior lumbar vertebral osteophytes (ALVO), minimum diameter of LIV, the number of sites of LIV stenosis, proportion of cases with percentage compression of LIV ≥ 75%, proportion of cases with triple or dual LIV stenosis showed significant difference between the two groups (all P ˂0.05). Logistic regression analysis showed ALVO [odds ratio (OR) = 3.852, P = 0.025], number of sites of LIV stenosis [OR = 2.654, P = 0.027] and minimum diameter of LIV [OR = 0.585, P = 0.010] were all significant for VLUs.

Conclusions

The factors of ALVO and number of sites of LIV stenosis were risk factors, whereas minimum diameter of LIV was a protective factor for VLUs. This provided a direction for preoperative planning of non-thrombotic LIV stenting.

Graphical abstract