Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep;143(9):5833-5842.
doi: 10.1007/s00402-023-04811-3. Epub 2023 Feb 17.

Iliac vein compression syndrome by lumbar degenerative changes is associated with deep vein thrombosis after total knee arthroplasty

Jun-Ho Kim  1 , Seul Ki Lee  2 , Jee-Young Kim  3
Affiliations

Iliac vein compression syndrome by lumbar degenerative changes is associated with deep vein thrombosis after total knee arthroplasty

Jun-Ho Kim et al. Arch Orthop Trauma Surg. 2023 Sep.

Abstract

Introduction: This study aimed to identify whether iliac vein compression syndrome(IVCS) is associated with deep vein thrombosis(DVT) after total knee arthroplasty(TKA) and whether lower lumbar degenerative changes were risk factors for IVCS.

Materials and methods: A total of 259 consecutive patients who underwent TKA from January 2019 to March 2022 was retrospectively reviewed. Preoperative plain radiographs of lumbar spines and CT venography (CTV) for DVT diagnosis at postoperative 7 days were performed in all patients. Imaging findings of lower lumbar degenerative changes were analyzed on plain radiograph including lateral osteophytes, scoliosis, lateralolisthesis, retrolisthesis, anterolisthesis, and lower lumbar lordosis angle (LLLA). Percent compression at the left common iliac vein (LCIV) and right common iliac vein (RCIV) as well as DVT were evaluated on CTV. Moreover, IVCS was defined as greater than 50% of compression of the iliac vein on CTV.

Results: DVT occurred in 79 patients (30.5%) after TKA. The overall occurrence of DVT was significantly higher in patients with IVCS of LCIV (52.8%) than those without (18.8%, P < 0.001). When DVT was further subdivided, compared to non-IVCS, IVCS of LCIV was significantly associated with bilateral DVT (P < 0.001, both), especially distal DVT (P < 0.001, both), and IVCS of RCIV was significantly associated with right-side DVT (P = 0.031), especially popliteal (P = 0.008) and distal DVT(P = 0.011). Female patients (OR: 3.945, P = 0.039), presence of left osteophyte (OR: 2.348, P = 0.006), and higher LLLA (OR: 1.082, P < 0.001) were significantly associated with IVCS of LCIV, and presence of right osteophyte (OR: 3.494, P = 0.017) was significantly associated with IVCS of RCIV.

Conclusion: IVCS was significantly associated with DVT after TKA and lumbar degenerative changes with lateral osteophytes and hyperlordosis were significant risk factors for IVCS.

Keywords: Deep vein thrombosis; Degenerative lumbar spondylosis; Iliac vein compression syndrome; Lumbar lordosis; Total knee arthroplasty.

PubMed Disclaimer

References

    1. Birn J, Vedantham S (2015) May-Thurner syndrome and other obstructive iliac vein lesions: meaning, myth, and mystery. Vasc Med 20:74–83. https://doi.org/10.1177/1358863x14560429 - DOI - PubMed
    1. Mousa AY, AbuRahma AF (2013) May-Thurner syndrome: update and review. Ann Vasc Surg 27:984–995. https://doi.org/10.1016/j.avsg.2013.05.001 - DOI - PubMed
    1. Narese D, Bracale UM, Vitale G, Porcellini M, Midiri M, Bracale G (2015) What the young physician should know about May-Thurner syndrome. Transl Med UniSa 12:19–28 - PubMed
    1. Li J, Chen H, Chen W, Zhou K, Xu Z, Xu M, Sun Z (2021) Novel typing of iliac vein compression in asymptomatic individuals evaluated by contrast enhanced CT. Surg Radiol Anat 43:1149–1157. https://doi.org/10.1007/s00276-021-02678-w - DOI - PubMed - PMC
    1. Brinegar KN, Sheth RA, Khademhosseini A, Bautista J, Oklu R (2015) Iliac vein compression syndrome: Clinical, imaging and pathologic findings. World J Radiol 7:375–381. https://doi.org/10.4329/wjr.v7.i11.375 - DOI - PubMed - PMC

MeSH terms

LinkOut - more resources