Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.190060
Jornal Vascular Brasileiro
Original Article

Prevalência de compressão da veia ilíaca esquerda em imagens tomográficas de uma população

Prevalence of left iliac vein compression on computed tomography scans from a population

Mateus Picada Corrêa; Guilherme Soldatelli Kurtz; Larissa Bianchini; Lauren Copatti; Marcelo Ribeiro; Jaber Nashat Saleh; Rafael Stevan Noel; Julio Cesar Bajerski

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Resumo

Resumo: Contexto: A síndrome de May-Thurner (SMT) é a compressão da veia ilíaca esquerda (VIE) entre a artéria ilíaca direita e o corpo vertebral associada à hipertensão venosa crônica unilateral no membro inferior esquerdo. Porém, o achado tomográfico da compressão não necessariamente se reflete em sintomas.

Objetivos: Avaliar o achado de compressão da veia ilíaca esquerda em tomografias realizadas por outros motivos.

Métodos: Angiotomografias ou tomografias computadorizadas (TCs) com fase venosa foram analisadas. Foram coletados os dados demográficos e o motivo do exame, quando presente, e foi analisada a relação do diâmetro da veia ilíaca esquerda no ponto de maior compressão com um ponto a montante.

Resultados: De janeiro a julho de 2016, 590 tomografias foram analisadas, sendo 357 de mulheres e 233 de homens. A compressão da VIE ocorreu em 87 (14,74%) pacientes, dos quais 74 (85,05%) eram mulheres e 13 (14,9%) homens. O diâmetro médio do ponto de maior compressão entre os pacientes que apresentavam VIE < 5 mm foi de 4,4 mm, variando de 2,67 mm a 4,97 mm. O diâmetro no ponto de maior compressão representou até metade do diâmetro na última imagem justaposta ao corpo vertebral (índice de 0,5) em 179 (30,3%) dos pacientes.

Conclusões: Nosso estudo sugere que a ocorrência de compressão da VIE em TC de pacientes aleatórios, sem conhecimento de insuficiência venosa crônica ou TVP em MIE, é comum. Isso mostra que o achado tomográfico de compressão não necessariamente resulta em sintomas e não deve ser a única razão para tratar um paciente.

Palavras-chave

insuficiência venosa, síndrome de May-Thurner, varizes

Abstract

Background: May-Thurner syndrome (MTS) is defined as compression of the left iliac vein between the right iliac artery and the lumbar vertebral body in the presence of signs and symptoms of unilateral left chronic venous insufficiency. However, imaging findings of compression are not manifest in symptoms of the syndrome in all subjects. Objectives: To evaluate findings of compression in an asymptomatic population. Methods: Computed tomography angiographies or venous phase computed tomographies were analyzed. Demographic data and reason for the exam were recorded. Vein diameter was measured at the site of greatest compression and distal of the compression and the ratio between the two diameters was calculated. Results: From January to July of 2016, 590 computed tomography scans were analyzed (357 women and 233 men). Left iliac compression was found in 14.74% of patients. Patients with a left iliac diameter below the 5mm threshold had a mean diameter at the site of greatest iliac vein compression of 4.4 mm (range: 2.67 mm-4.97 mm). The ratio between the two measurements was < 0.5 in 30% of patients. Conclusions: Our study suggests that iliac vein compression is common among random patients who have had computed tomography for any other reason. This indicates that compression found on tomography images is not the only finding to consider when treating a patient.

Keywords

venous insufficiency; May-Thurner syndrome; varicose veins.

References

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