Experience in Treating Eight Cases of Pelvic Congestion Syndrome

Pelvic congestion syndrome presents chronic pelvic pain, atypical varicose veins, recurrent varicose veins or leg pain. The cause of these symptoms is reflux of the left ovarian vein. We report our experience in treating eight cases of pelvic congestion syndrome with reflux of the left ovarian vein....

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Published in:	Jōmyakugaku : Nihon Jōmyaku Gakkai kikanshi = The Japanese journal of phlebology Vol. 34; no. 3; pp. 351 - 356
Main Authors:	Kume, Hiroko, Koizumi, Shinya, Sakurazawa, Kenichi, Honma, Kaori, Kishino, Mitsuhiro, Iwai, Takehisa
Format:	Journal Article
Language:	English Japanese
Published:	Japanese Society of Phlebology 10-08-2023
Subjects:	coil embolization pelvic congestion syndrome perineal varices recurrent varicose veins reflux of the left ovarian vein
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Abstract	Pelvic congestion syndrome presents chronic pelvic pain, atypical varicose veins, recurrent varicose veins or leg pain. The cause of these symptoms is reflux of the left ovarian vein. We report our experience in treating eight cases of pelvic congestion syndrome with reflux of the left ovarian vein. The patients were treated with EVLA and sclerotherapy for varicose veins in the lower limbs or perineal varices, and coil embolization of the left ovarian vein was performed in 7 cases. After coil embolization in 7 patients, 4 patients had residual or recurrent ovarian vein reflux. One of them underwent coil embolization of the left ovarian vein again due to recurrence of symptoms. All patients, including the one who underwent repeat embolization, had symptomatic relief. There were no complications or worsening of symptoms due to coil embolization. Coil embolization of the ovarian vein is effective in improving symptoms with few serious complications.
AbstractList	Pelvic congestion syndrome presents chronic pelvic pain, atypical varicose veins, recurrent varicose veins or leg pain. The cause of these symptoms is reflux of the left ovarian vein. We report our experience in treating eight cases of pelvic congestion syndrome with reflux of the left ovarian vein. The patients were treated with EVLA and sclerotherapy for varicose veins in the lower limbs or perineal varices, and coil embolization of the left ovarian vein was performed in 7 cases. After coil embolization in 7 patients, 4 patients had residual or recurrent ovarian vein reflux. One of them underwent coil embolization of the left ovarian vein again due to recurrence of symptoms. All patients, including the one who underwent repeat embolization, had symptomatic relief. There were no complications or worsening of symptoms due to coil embolization. Coil embolization of the ovarian vein is effective in improving symptoms with few serious complications.
ArticleNumber	23-5
Author	Kishino, Mitsuhiro Kume, Hiroko Sakurazawa, Kenichi Iwai, Takehisa Honma, Kaori Koizumi, Shinya
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References	2) Antignani PL, Lazarashvili Z, Monedero JL, et al: Diagnosis and treatment of pelvic congestion syndrome: UIP consensus document. Int Angiol 2019; 38: 265–283 8) Rabe E, Pannier F: Embolization is not essential in the treatment of leg varices due to pelvic venous insufficiency. Phlebology 2015; 30 Suppl: 86–88 9) Asciutto G, Asciutto KC, Mumme A, et al: Pelvic venous incompetence: reflux patterns and treatment results. Eur J Vasc Endovasc Surg 2009; 38: 381–386 10) Kim HS, Malhotra AD, Rowe PC, et al: Embolotherapy for pelvic congestion syndrome: long-term results. J Vasc Interv Radiol 2006; 17: 289–297 1) Brown CL, Rizer M, Alexander R, et al: Pelvic congestion syndrome: systematic review of treatment success. Semin Intervent Radiol 2018; 35: 35–40 6) Castenmiller PH, De Leur K, De Jong TEAM, et al: Clinical results after coil embolization of the ovarian vein in patients with primary and recurrent lower-limb varices with respect to vulval varices. Phlebology 2013; 28: 234–238 11) Lemasle P, Greiner G: Duplex ultrasound investigation in pelvic congestion syndrome: technique and results. Phlebolymphology 2017; 24: 79–87 3) Szary C, Wilczko J, Zawadzki M, et al: Hemodynamic and radiological classification of ovarian veins system insufficiency. J Clin Med 2021; 10: 646 4) Meissner MH, Khilnani NM, Labropoulos N, et al: The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: a report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders. J Vasc Surg Venous Lymphat Disord 2021; 9: 568–584 5) Bałabuszek K, Toborek M, Pietura R: Comprehensive overview of the venous disorder known as pelvic congestion syndrome. Ann Med 2022; 54: 22–36 7) De Maeseneer MG, Kakkos SK, Aheme T, et al: European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs. Eur J Vasc Endovasc Surg 2022; 63: 184–267 11 1 2 3 4 5 6 7 8 9 10
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SubjectTerms	coil embolization pelvic congestion syndrome perineal varices recurrent varicose veins reflux of the left ovarian vein
Title	Experience in Treating Eight Cases of Pelvic Congestion Syndrome
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