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Correlation Of Ivus, Venogram, And Balloonogram To Evaluate Ilio-femoral Vein Disorders (IFVD)
Adila Ahmed, B.S., Sam S. Ahn, M.D..
DFW Vascular Group, Dallas, TX, USA.
OBJECTIVES: Intravascular ultrasound (IVUS) and venogram are commonly utilized to identify stenosis with IVUS being the gold standard. This study compares the accuracy of venogram and balloonagram to IVUS in patients undergoing treatment for IFVD.
METHODS: We retrospectively reviewed 415 patient charts with venous diagnoses between 2011 to 2022. We excluded 162 patients without a balloonagram during the procedure, leaving 253 patients who had IVUS, balloonagram, and venography findings recorded. The average age was 70 years, ranging from 30 to 96. We had 143 females and 109 males. The indications include compression of veins (89.7%), phlebitis and thrombophlebitis of deep veins (2.4%), venous embolism and thrombosis (17.5%), venous insufficiency (4%), and chronic venous hypertension (12.7%). We studied the common femoral, common iliac, external iliac, and superficial femoral veins. We compared whether both methods show < 50% or > 50% stenosis for the following categories: venogram and IVUS, venogram and balloonagram, and IVUS and balloonagram. The correlations were calculated using the software R.
RESULTS: The average similarity between venogram and IVUS amongst the five deep veins is 61.99%, between balloonagram and IVUS is 80.73%, and between venogram and balloonagram is 58.07%. Venograms missed 40% of the IVUS stenosis findings and balloonagrams missed 20% of the IVUS stenosis findings.
CONCLUSIONS: We recommend that IVUS should be utilized in every case as it is the gold standard and has the highest accuracy rate. If IVUS is not available, then balloonagram should be performed as a supplement to venogram to increase accuracy.
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