Villegas-Cabello Ó, Carrillo-Martínez MÄ, Álvarez-Arrazola DM, Valles-Guerra O

Language: Spanish
References: 12
Page: 100-105
PDF size: 162.56 Kb.

ABSTRACT

Objective: To present our initial experience in the endovascular treatment of pelvic congestion syndrome (PCS). Expose a brief literature revision.
Background: PCS is a clinical entity traditionally managed by gynecologists and gastrointestinal specialists. The patients usually refer vulvar varicose veins, abdominal distention and discomfort. The mainstay of the diagnostic process is Doppler ultrasound. Upon a positive ultrasound examination the patient may undergo diagnostic venogram and embolization. Patients submitted to endovascular occlusion refer significant improvement and high welfare index.
Material and methods: Descriptive trial (case series) including patients diagnosed on PCS. The diagnosis was documented with Doppler ultrasound and the patients were submitted to ovarian and pelvic selective venograms. Ovarian vein embolization with coils and tetradecyl sulfate foam was performed in the veins with documented reflux. Six patients were included. Follow up was done on the basis of clinical interviews. A standardized questionnaire was applied. Average follow up period was 15.1 months.
Results: Affected veins were successfully embolized in all six patients. However one of them did not improve. She underwent a second venogram and a missed accessory left ovarian vein was encountered and successfully embolized. After the second procedure the patient’s symptoms disappeared.
Conclusions: Patients with PCS do not consider a vascular consultation as first line of treatment. Endovascular treatment is a minimal invasive alternative that allows preservation of the uterus and shows a high index of clinical satisfaction. Medical and patient education will promote the use of this treatment modality.

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