Objectives
Iliac vein outflow stenosis is a major cause of pelvic and/or lower extremity symptoms in patients. Despite its prevalence, there is limited data on presentation patterns based on race. The purpose of this investigation was to evaluate the presentation patterns of patients with iliac vein outflow stenosis based on race.
Methods
From November 2011 to April 2023, a total of 25,824 patients presented to the Center for Vascular Medicine (CVM) for evaluation of iliac vein outflow stenosis. Of these, 9159 were excluded due to incomplete data. The remaining 16,665 patients were divided into the following racial groups: African American, Asian, Hispanic, Other, and White. Past medical and surgical history, presenting signs and symptoms, treatment types, preintervention and postintervention revised venous clinical severity scores (rVCSSs), visual analog pain scores (VAS), and CEAP classification were evaluated. Patients who received treatment were treated with iliac vein stenting (IVS), ovarian vein embolization (OVE), or both.
Results
The average age of the entire cohort was 59.8 ± 15.4 years, with 10,998 women (66%) and 5667 men (34%). The race distribution was 37% African American, 2% Asian, 9% Hispanic, 50% White, and 2% Other races. There were no significant differences in age by race group. Hispanics had a greater proportion of females (80%) compared with other race groups, whereas Asians and Other races had the lowest proportion of females (both 59%). The CEAP distribution in the entire cohort was as follows: 22% C0; 7% C1; 6% C2; 36% C3; 22% C4; 3% C5; and 4% C6. Prevalence of C6 disease was highest among African Americans (4.10%) and lowest among Asians (1.69%; P < .05). The average rVCSS and VAS at time of presentation were 4.62 ± 3.44, and 4.38 ± 3.61, respectively, with no significant differences noted by race (P = .99). Of the 16,665 total patients, 2687 patients were treated (16%), and a total of 3913 procedures were performed. Of the subset of patients who received at least one treatment, the average number of procedures per patient was 1.46 ± 0.07. The percentage of patients treated in each group was as follows: 23% of Hispanics; 20% of Whites; 11% of other races; 10% of Asians; and 9.6% of African Americans. Hispanics and Whites were treated most frequently (23% and 20%, respectively), whereas African Americans and Asians were treated least frequently (9.6% and 10%, respectively; P < .05).
Conclusions
There are no differences in disease severity at initial presentation according to rVCSS and VAS based on race. African Americans have a higher incidence of C6 disease compared with other racial groups. Hispanics and Whites were treated most often, whereas African Americans and Asians were treated the least frequently.
