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Title: Pelvic Vein Embolisation in the Management of Varicose Veins

Abstract

Pelvic vein incompetence is common in patients with atypical varicose veins, contributing to their recurrence after surgery. Therefore, refluxing pelvic veins should be identified and treated. We present our experience with pelvic vein embolisation in patients presenting with varicose veins. Patients presenting with varicose veins with a duplex-proven contribution from perivulval veins undergo transvaginal duplex sonography (TVUS) to identify refluxing pelvic veins. Those with positive scans undergo embolisation before surgical treatment of their lower limb varicose veins. A total of 218 women (mean age of 46.3 years) were treated. Parity was documented in the first 60 patients, of whom 47 (78.3%) were multiparous, 11 (18.3%) had had one previous pregnancy, and 2 (3.3%) were nulliparous. The left ovarian vein was embolised in 78%, the right internal iliac in 64.7%, the left internal iliac in 56.4%, and the right ovarian vein in 42.2% of patients. At follow-up TVUS, mild reflux only was seen in 16, marked persistent reflux in 6, and new reflux in 3 patients. These 9 women underwent successful repeat embolisation. Two patients experienced pulmonary embolisation of the coils, of whom 1 was asymptomatic and 1 was successfully retrieved; 1 patient had a misplaced coil protruding into the commonmore » femoral vein; and 1 patient had perineal thrombophlebitis. The results of our study showed that pelvic venous embolisation by way of a transjugular approach is a safe and effective technique in the treatment of pelvic vein reflux.« less

Authors:
 [1]; ; ;  [2];  [3];  [2];  [3]
  1. St. George's Hospital, Department of Radiology (United Kingdom)
  2. Stirling House, Whiteley Clinic (United Kingdom)
  3. Royal Surrey County Hospital, Department of Radiology (United Kingdom)
Publication Date:
OSTI Identifier:
21450314
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 31; Journal Issue: 6; Other Information: DOI: 10.1007/s00270-008-9402-9; Copyright (c) 2008 Springer Science+Business Media, LLC; Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; PELVIS; VEINS; WOMEN; ANIMALS; BLOOD VESSELS; BODY; CARDIOVASCULAR SYSTEM; FEMALES; MAMMALS; MAN; ORGANS; PRIMATES; VERTEBRATES

Citation Formats

Ratnam, Lakshmi A, Marsh, Petra, Holdstock, Judy M, Harrison, Charmaine S, Hussain, Fuad F, Whiteley, Mark S, and Lopez, Anthony. Pelvic Vein Embolisation in the Management of Varicose Veins. United States: N. p., 2008. Web. doi:10.1007/S00270-008-9402-9.
Ratnam, Lakshmi A, Marsh, Petra, Holdstock, Judy M, Harrison, Charmaine S, Hussain, Fuad F, Whiteley, Mark S, & Lopez, Anthony. Pelvic Vein Embolisation in the Management of Varicose Veins. United States. https://doi.org/10.1007/S00270-008-9402-9
Ratnam, Lakshmi A, Marsh, Petra, Holdstock, Judy M, Harrison, Charmaine S, Hussain, Fuad F, Whiteley, Mark S, and Lopez, Anthony. 2008. "Pelvic Vein Embolisation in the Management of Varicose Veins". United States. https://doi.org/10.1007/S00270-008-9402-9.
@article{osti_21450314,
title = {Pelvic Vein Embolisation in the Management of Varicose Veins},
author = {Ratnam, Lakshmi A and Marsh, Petra and Holdstock, Judy M and Harrison, Charmaine S and Hussain, Fuad F and Whiteley, Mark S and Lopez, Anthony},
abstractNote = {Pelvic vein incompetence is common in patients with atypical varicose veins, contributing to their recurrence after surgery. Therefore, refluxing pelvic veins should be identified and treated. We present our experience with pelvic vein embolisation in patients presenting with varicose veins. Patients presenting with varicose veins with a duplex-proven contribution from perivulval veins undergo transvaginal duplex sonography (TVUS) to identify refluxing pelvic veins. Those with positive scans undergo embolisation before surgical treatment of their lower limb varicose veins. A total of 218 women (mean age of 46.3 years) were treated. Parity was documented in the first 60 patients, of whom 47 (78.3%) were multiparous, 11 (18.3%) had had one previous pregnancy, and 2 (3.3%) were nulliparous. The left ovarian vein was embolised in 78%, the right internal iliac in 64.7%, the left internal iliac in 56.4%, and the right ovarian vein in 42.2% of patients. At follow-up TVUS, mild reflux only was seen in 16, marked persistent reflux in 6, and new reflux in 3 patients. These 9 women underwent successful repeat embolisation. Two patients experienced pulmonary embolisation of the coils, of whom 1 was asymptomatic and 1 was successfully retrieved; 1 patient had a misplaced coil protruding into the common femoral vein; and 1 patient had perineal thrombophlebitis. The results of our study showed that pelvic venous embolisation by way of a transjugular approach is a safe and effective technique in the treatment of pelvic vein reflux.},
doi = {10.1007/S00270-008-9402-9},
url = {https://www.osti.gov/biblio/21450314}, journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 6,
volume = 31,
place = {United States},
year = {Sat Nov 15 00:00:00 EST 2008},
month = {Sat Nov 15 00:00:00 EST 2008}
}