Clinical characteristics and treatment outcomes of 68 patients with spontaneous iliac vein rupture: A case report and systematic review

作者全名："Li, Zhui; Feng, Yangyang; Wei, Miao; Cui, Hong; Zeng, Qiu; Huang, Wen; Ren, Wei; Zhao, Yu"

作者地址："[Li, Zhui; Feng, Yangyang; Zeng, Qiu; Huang, Wen; Ren, Wei; Zhao, Yu] Chongqing Med Univ, Affiliated Hosp 1, Dept Vasc Surg, 1 Youyi Rd, Chongqing 400016, Peoples R China; [Wei, Miao] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, Chongqing, Peoples R China; [Cui, Hong] Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesia, Chongqing, Peoples R China"

通信作者："Ren, W; Zhao, Y (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Vasc Surg, 1 Youyi Rd, Chongqing 400016, Peoples R China."

来源：HELIYON

ESI学科分类：　

WOS号：WOS:001043417200001

JCR分区：Q1

影响因子：3.4

年份：2023

卷号：9

期号：6

开始页：　

结束页：　

文献类型：Review

关键词：Spontaneous iliac vein rupture; Clinical characteristics; Risk factor; May; Thurner syndrome; Hemodynamics; Deep vein thrombosis

摘要："Objective: Spontaneous iliac vein rupture (SIVR) is a rare but life-threatening condition with limited understanding regarding its clinical presentation, pathogenesis, diagnosis, management, and risk factors for mortality. This study aims to address this gap by providing comprehensive insights into SIVR through personal case reports and a systematic review of previous cases.Methods: We detail a case of right SIVR caused by inappropriate positioning of the stent in the inferior vena cava and systematically reviewed previous cases. Logistic regression analysis was used to identify risk factors for mortality.Results: Our SIVR case was successfully managed with percutaneous mechanical thrombectomy and covered stent placement. In the systematic review, 68 patients were included in the analysis with an average age of 62.01 & PLUSMN; 13.25 years; 86.76% were female, 91.17% had left iliac vein rupture, 55.88% presented hemodynamic instability, 76.47% had lower abdomen or iliac fossa pain, 67.64% had deep venous thrombosis (DVT), and 32.35% had May-Thurner syndrome (MTS). The mortality rates of conservative treatment and open surgery were 2.94% and 17.65%, respectively. All 12 patients receiving endovascular treatment survived. The factors associated with a worse outcome were younger age (52.86 & PLUSMN; 12.96 years, OR: 1.085, 95% CI: 1.002-1.174) and SIVR patients without DVT (OR:10.111, 95% CI: 1.637-62.443).Conclusion: This first systematic review on SIVR shows that SIVR should be highly suspected in elderly females who develop lower extremity DVT and concurrent lower abdominal pain, particularly those with a retroperitoneal mass and unstable hemodynamics. Thrombosis sec-ondary to MTS may be the main cause of SIVR. Angiography and endovascular therapy should be prioritized for DVT patients with unexplained retroperitoneal hematoma. This study classifies SIVR into two types: iliac vein rupture alone and iliac vein rupture with DVT. These findings provide critical insights for clinicians to accurately diagnose and manage SIVR, thereby improving patient outcomes."

基金机构：training foundation of the First Affiliated Hospital of Chongqing Medical University [PYJJ2018-03]

基金资助正文：& nbsp;The research was supported by the training foundation of the First Affiliated Hospital of Chongqing Medical University (grant number PYJJ2018-03 to Li Zhui) .