Endovascular interventions in the treatment of pelvic congestion syndrome caused by May-Thurner syndrome

Sg, Gavrilov; Vasilyev, Alexey V.; Krasavin, G.V.; Moskalenko, Yekaterina P.; Mishakina, N.Yu.

doi:10.1016/j.jvsv.2020.02.012

Cited by 26 publications

(15 citation statements)

References 22 publications

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“…16 However, a more recent study including 12 patients suggested that symptomatic relief of patients with pelvic venous disease was only 16.6% when only stenting was performed, and suggested that ovarian vein embolization should be performed 6 months after stenting. 17 These findings supported the data from a previous study involving a larger number of patients (n ¼ 277) published in 2018 which found that 80% of patients had both gonadal vein insufficiency and iliac vein compression, and advocated for the treatment of venous stenosis first followed by ovarian vein embolization subsequently if symptoms persist, but suggested that patients with large pelvic reservoirs receive simultaneous treatment. 22…”

Section: Treatment Selectionsupporting

confidence: 87%

“…Daugherty and Gillespie demonstrated successful clinical outcomes in patients with PeVD and iliac vein stenting alone, while Gavrilov et al found that stent alone was not sufficient to completely improve symptoms in a patient population with predominant CPP and C1 venous disease and additional interventions were needed. 16,17…”

Section: Venous Compressionmentioning

confidence: 99%

“…Previous data have shown that a proportion (16.6%) of patients with pelvic venous disease and iliac vein stenosis have vulvar varices that required adjunctive procedures for treatment. 17 In our clinical practice, fluoroscopic and/or ultrasound guidance is used to directly access these veins, perform venography, and perform sclerotherapy with foam. Fluoroscopic guidance is advantageous in that it is more amenable to close drug dose titration and control of the injection to the level of the normal pelvic veins, which reduces the risk of nontarget sclerotherapy.…”

Section: Iliac Compression With Vulvar and Superficial Nonsaphenous Varicesmentioning

confidence: 99%

“…37 Stent migration has been previously described with Wallstent and this complication was addressed with stabilization via a second stent. 17 Thrombotic complications are rare in patients who do not have a prior history of venous thrombosis at initial presentation. 22 Additionally, when patients become pregnant, there are no specific guidelines for anticoagulation, but there is a theoretical risk of stent compression due to the growing fetus.…”

Section: Complicationsmentioning

confidence: 99%

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Choosing the Most Appropriate Treatment Option for Pelvic Venous Disease: Stenting versus Embolization

Tanaka

Kutsenko

Salazar

2021

Semin intervent Radiol

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Pelvic venous disease (PeVD) in women encompasses a wide variety of entities all resulting in pelvic pain and varices. Successful treatment with percutaneous interventions is dependent on identifying underlying factors contributing to the disease and addressing them with either embolization of incompetent veins or stenting for venous stenoses. There are a multitude of embolization methods with marked practice heterogeneity. Moreover, with the ongoing development of dedicated venous stents in the treatment of chronic venous disease, there are more opportunities to consider this modality for the treatment of PeVD, as many patients present with combined vein reflux and central venous stenosis. The necessity to address both and the order of interventions in these patients is still to be elucidated. Here, we describe when to choose stenting or embolization for PeVD, their limitations, and our practice and identify further areas of research in this field.

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Section: Treatment Selectionsupporting

confidence: 87%

Section: Venous Compressionmentioning

confidence: 99%

Section: Iliac Compression With Vulvar and Superficial Nonsaphenous Varicesmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

See 2 more Smart Citations

Choosing the Most Appropriate Treatment Option for Pelvic Venous Disease: Stenting versus Embolization

Tanaka

Kutsenko

Salazar

2021

Semin intervent Radiol

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“…When stenosis is present, representing a hemodynamically significant problem, removal of the obstruction should be undertaken [ 113 ]. However, stenting of the left CIV without embolisation of gonadal veins relieves symptoms of PCS due to May-Thurner Syndrome in only 16.6% of patients [ 114 ]. Different results were published by Lakhanpal et al.…”

Section: Treatmentmentioning

confidence: 99%

Comprehensive overview of the venous disorder known as pelvic congestion syndrome

2021

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Pelvic venous disorders (PeVD) also known as Pelvic Congestion Syndrome (PCS) affect a great number of women worldwide and often remain undiagnosed. Gynecological symptoms caused by vascular background demand a holistic approach for appropriate diagnosis. This is a relevant cause of chronic pelvic pain and atypical varicose veins. The diagnosis is based on imaging studies and their correlation with clinical presentation. Although the aetiology of PCS still remains unclear, it may result from a combination of factors including genetic predisposition, anatomical abnormalities, hormonal factors, damage to the vein wall, valve dysfunction, reverse blood flow, hypertension and dilatation. The following paper describes an in-depth overview of anatomy, pathophysiology, symptoms, diagnosis and treatment of PCS. In recent years, minimally invasive interventions have become the method of first choice for the treatment of this condition. The efficacy of a percutaneous approach is high and it is rarely associated with serious complications. Key Messages Pelvic venous disorders demand a holistic approach for appropriate diagnosis. This article takes an in-depth look at existing therapies of Pelvic Congestion Syndrome and pathophysiology of this condition. Embolisation is an effective and safe treatment option.

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Diagnostics and treatment of pelvic congestion syndrome

Mühlberger,

Hummel

2024

Gefässchirurgie

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Endovascular interventions in the treatment of pelvic congestion syndrome caused by May-Thurner syndrome

Cited by 26 publications

References 22 publications

Choosing the Most Appropriate Treatment Option for Pelvic Venous Disease: Stenting versus Embolization

Choosing the Most Appropriate Treatment Option for Pelvic Venous Disease: Stenting versus Embolization

Comprehensive overview of the venous disorder known as pelvic congestion syndrome

Diagnostics and treatment of pelvic congestion syndrome

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