AB182. SOH22ABS214. Diagnostic accuracy of venograms for assessment of chronic venous disease: a systematic review

Background: Patients with symptoms of chronic venous insufficiency may have proximal vein stenosis, limiting the success of surgical intervention. It is unclear whether routine evaluation of the deep veins aids patient management. Intravascular ultrasound (IVUS) is considered the gold standard in diagnosing iliac and iliac/inferior vena cava (IVC) compression. The objective of this review was to determine if venography alone has acceptable diagnostic performance to rule out a pelvic vein component in patients who present with chronic venous insufficiency.

Methods: PubMed, Embase, and Cochrane Library databases were searched using appropriate terms for all studies reporting on venogram compared to IVUS for the diagnosis of deep venous dysfunction. Additional studies were identified from reference. The Quality Appraisal of Reliability (QAREL) Checklist tool was used to assess the quality of studies of diagnostic reliability. The systematic review was conducted according to PRISMA guidelines.

Results: One thousand nine hundred and fifty-four articles were identified, with 7 deemed eligible for inclusion. This consisted of 1,064 patients (374 males, 690 females, mean age of 58 years). The index test used in all studies was a venogram, either direct or catheter directed, and the reference test in all studies was IVUS. Sensitivity of venogram ranged from 58–87%, with a pooled sensitivity of 75%. Specificity of venogram was 100%.

Conclusions: This systematic review suggests that a screening venogram would be useful to evaluate patients presenting with CVD for iliac vein lesions. The low number of eligible studies more research is needed in the area, however based the findings of this systematic review, a screening venogram will add value in the assessment of CVD/CVI patients.

Keywords: Chronic venous insufficiency; deep vein; iliac vein stenosis; intravascular ultrasound (IVUS); venogram