Hemodynamic insight into the iliac vein after stent intervention: Mind the persistent compression of iliac vein stent

Abstract

This study hypothesizes that lumbar spine and iliac artery compression of veins persists after stenting, rendering the iliac vein susceptible to restenosis, thrombosis, and other clinical complications. To examine this hypothesis, a vascular model post-iliac vein stenting was constructed based on vein images from patients with iliac vein compression syndrome. This model facilitated the examination of how varying degrees of compression affect the hemodynamic environment of the host vasculature post-stenting. Results indicated that while compression increased blood flow velocity near the affected area, it also led to a more disturbed blood flow environment within the stent segment, at bifurcation points, and in the contralateral iliac vein, as evidenced by elevated Oscillatory Shear Index (OSI) and Relative Residence Time (RRT) values. Furthermore, the study observed that while the implantation of long stents minimally impacted the blood vessels within the stent segment, it did marginally mitigate adverse blood flow conditions at intersections under compression. Consequently, the ongoing adverse effects of compression on the flow environment post-stenting, potentially linked to suboptimal postoperative outcomes at these sites, should be carefully considered.