Tratamento endovascular de síndrome congestiva venosa pélvica em paciente com duplicação de veia cava inferior e anatomia venosa pélvica incomum: revisão bibliográfica

Lima, Marcelo Fernandes; Lima, Ilídio Almeida; Heinrich-Oliveira, Vanessa

doi:10.1590/1677-5449.190017

Cited by 3 publications

(1 citation statement)

References 18 publications

(37 reference statements)

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“…Dysfunctional venous valves, a vasodilatory effect of estrogen, and impaired involution after mechanical injury in late pregnancy have been proposed to cause primary PCS [ 6 , 7 ]. Secondary PCS is characterized by anatomical obstruction, such as the venous compression in nutcracker or May-Thurner syndromes [ 3 , 8 ]. Despite etiological differences, either type of PCS is similarly characterized by an increase in the volume of pelvic veins in combination with characteristic pain, which tends to worsen toward the end of the day or after long periods of standing due to orthostatic pressure.…”

Section: Introductionmentioning

confidence: 99%

Pelvic congestion syndrome (PCS) as a pathology of postmenopausal women: a case report with literature review

2021

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Background Due to the scarcity of adequately powered, randomized controlled trials and internationally standardized diagnostic criteria, evidence on the diagnosis and treatment of pelvic congestion syndrome (PCS) is limited. Earlier epidemiologic observations led to the attribution of PCS to the premenopausal state, and a remission of symptoms after menopause is frequently described a hallmark of the pathology. This concept has currently been challenged by radiological studies reporting a notable prevalence of ovarian venous congestion in adult female patients of advanced age. PCS as a pathology of postmenopausal women, however, has not been acknowledged by systematic research to date, impeding appropriate diagnostics and therapy for affected patients. Case presentation A 69-year-old postmenopausal patient presented with newly diagnosed dilated and insufficient pelvic veins in combination with characteristic pain anamnesis, thereby fulfilling the diagnostic criteria of PCS. Interventional coil embolization of both ovarian veins as a standard treatment previously described for premenopausal patients was successfully performed, resulting in prompt alleviation of symptoms. The patient remained symptom-free at the 18-month follow-up visit. Conclusions Given this first systematically documented case of a patient with postmenopausal symptomatic PCS in the light of recently published data on the prevalence of ovarian venous congestion in patients of advanced age, it may be assumed that PCS is not to be considered a pathology strictly limited to premenopausal state. Further clinical studies expanding the diagnostic scope beyond menopause may help to substantiate evidence and subsequently define standardized therapeutic approaches for affected postmenopausal patients.

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Section: Introductionmentioning

confidence: 99%