Embolization of incompetent pelvic veins for the treatment of recurrent varicose veins in lower limbs and pelvic congestion syndrome

Cardiovasc Intervent Radiol. 2013 Feb;36(1):128-32. doi: 10.1007/s00270-012-0389-x. Epub 2012 May 1.

Abstract

Purpose: We present our experience with embolization of incompetent pelvic veins (IPV) in women with recurrence of varicose veins (VV) in lower limbs, as well as symptoms of pelvic congestion syndrome (PCS), after first surgery. In addition, we evaluated the effects of embolization in decreasing the symptoms of VV before surgery as well as its effects on PCS symptoms.

Materials and methods: We included 10 women who had consulted a vascular surgeon because of recurrent VV in lower limbs after surgery. All of these patients were included in the study because they also had symptoms of PCS, probably due to IPV. In patients who had confirmed IPV, we performed embolization before a second surgery. VV and PCS were assessed before and at 3 months after embolization (before the second surgery) using a venous clinical severity score (VCSS) and a visual analog pain scale (VAS), respectively. Patients were controlled between 3 and 6 months after embolization. Paired Student t test analysis was used for comparing data before and after embolization.

Results: Fifteen vein segments in 10 women were suitable for embolization. There was a significant (p < 0.001) decrease of VCSS after embolization, and recurrence of VV was not detected within a period of 6 months. There was also significant (p < 0.01) relief of chronic pelvic pain related to PCS evaluated using VAS at 3 months after embolization.

Conclusion: Embolization decreases the risk of VV recurrence after surgery and also improves PCS symptoms in women with VV in lower limbs and IPV.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Catheterization, Peripheral / methods
  • Cohort Studies
  • Embolization, Therapeutic / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Lower Extremity / diagnostic imaging
  • Pain Measurement
  • Patient Selection
  • Pelvic Pain / diagnostic imaging
  • Pelvic Pain / therapy*
  • Pelvis / blood supply*
  • Pelvis / diagnostic imaging
  • Phlebography / methods
  • Prospective Studies
  • Recurrence
  • Risk Assessment
  • Severity of Illness Index
  • Syndrome
  • Treatment Outcome
  • Varicose Veins / diagnostic imaging
  • Varicose Veins / therapy*
  • Veins
  • Venous Insufficiency / diagnostic imaging
  • Venous Insufficiency / therapy*