This journal is
indexed in Scopus
Year 2018 Vol. 26 No 6
GENERAL & SPECIAL SURGERY
O.I. NABOLOTNYI, Y.M. HUPALO, O.E. SHVED, V.G. GURIANOV
SURGICAL TREATMENT OF NON-SAPHENOUS VARICOSE VEINS OF LOWER LIMBS IN WOMEN WITH PELVIC CONGESTION SYNDROME
Scientific and Practical Center for Preventive and Clinical Medicine, Kiev,
Objective. To evaluate the effectiveness of endovascular interventions in the treatment of non-saphenous varicose veins of lower limbs in women with pelvic congestion syndrome.
Methods. The treatment analysis of non-saphenous varicose veins of the lower limbs combined with the pelvic congestion syndrome was conducted in 25 women. The main group consisted of 10 patients with non-saphenous varicose veins, pelvic varices and clinically expressed pelvic congestion syndrome. In this group, patients underwent pelvic phlebography with embolization of the left ovarian vein and miniphlebectomy of non-saphenous varicose veins. Control group included 15 patients with non-saphenous varicose veins, pelvic varices and with poorly expressed or absent clinic of pelvic congestion syndrome. In this group only miniphlebectomy of non-saphenous varicose veins was performed. The results of treatment were evaluated within 2 years. The incidence of varicose vein recurrence and pelvic pains was evaluated.
Results. During the a 2-year observation in 8 patients (80% (95%CI=46%-99%)) of the main group, the clinical symptoms of pelvic congestion syndrome regressed or significantly decreased. In 2 patients a chronic pelvic pain recurred to the intensity of the pre-hospital period. Relapses of varicose veins of the lower limbs were not observed. During a 2-year follow-up period, 1 (6.7%) patient of the control group had a recurrence of non-saphenous varicose in the lower limbs and 1 (6.7%) patient had relapse in the system of the great saphenous vein. In 2 (13%) patients, the intensity of pelvic pain increased.
Conclusions. The embolization of the left ovarian vein in patients with pelvic congestion syndrome, according to the study data, is effective in 80% of cases. Conducting the hybrid interference in case of varicose veins of the lower limbs and pelvic congestion syndrome is effective method for correction of pathological phlebohemodynamics in patients with chronic diseases of the lower limb and pelvic veins.
- Creton D, Hennequin L, Kohler F, Allaert FA. Embolisation of symptomatic pelvic veins in women presenting with non-saphenous varicose veins of pelvic origin - three-year follow-up. Eur J Vasc Endovasc Surg. 2007 Jul;34(1):112-17. doi: 10.1016/j.ejvs.2007.01.005
- Giannoukas AD, Dacie JE, Lumley JS. Recurrent varicose veins of both lower limbs due to bilateral ovarian vein incompetence. Ann Vasc Surg. 2000 Jul;14(4):397-400. doi: 10.1007/s100169910075
- Labropoulos N, Tiongson J, Pryor L, Tassiopoulos AK, Kang SS, Mansour MA, Baker WH. Nonsaphenous superficial vein reflux. J Vasc Surg. 2001 Nov;34(5):872-77. doi: 10.1067/mva.2001.118813
- Meissner MH, Moneta G, Burnand K, Gloviczki P, Lohr JM, Lurie F, Mattos MA, McLafferty RB, Mozes G, Rutherford RB, Padberg F, Sumner DS. The hemodynamics and diagnosis of venous disease. J Vasc Surg. 2007 Dec;46(Suppl S):4S-24S. doi: 10.1016/j.jvs.2007.09.043
- Steenbeek MP, van der Vleuten CJM, Schultze Kool LJ, Nieboer TE. Noninvasive diagnostic tools for pelvic congestion syndrome: a systematic review. Acta Obstet Gynecol Scand. 2018 Jan 30. doi: 10.1111/aogs.13311.
- Meneses L, Fava M, Diaz P, Andía M, Tejos C, Irarrazaval P, Uribe S. 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
- Perrin MR, Labropoulos N, Leon LR Jr. Presentation of the patient with recurrent varices after surgery (REVAS). J Vasc Surg. 2006 Feb;43(2):327-34; discussion 334. doi: 10.1016/j.jvs.2005.10.05
- Gibson K, Minjarez R, Ferris B, Neradilek M, Wise M, Stoughton J, Meissner M. Clinical presentation of women with pelvic source varicose veins in the perineum as a first step in the development of a disease-specific patient assessment tool. J Vasc Surg Venous Lymphat Disord. 2017 Jul;5(4):493-99. doi: 10.1016/j.jvsv.2017.03.012
- Dabbs E, Nemchand JL, Whiteley MS. Suprapubic varicose vein formation during pregnancy following pre-pregnancy pelvic vein embolisation with coils, without any residual pelvic venous reflux or obstruction. SAGE Open Med Case Rep. 2017 Aug 8;5:2050313X17724712. doi: 10.1177/2050313X17724712. eCollection 2017.
- Beckett D, Dos Santos SJ, Dabbs EB, Shiangoli I, Price BA, Whiteley MS. Anatomical abnormalities of the pelvic venous system and their implications for endovascular management of pelvic venous reflux. Phlebology. 2017 Jan 1:268355517735727. doi: 10.1177/0268355517735727
- Kachlik D, Pechacek V, Musil V, Baca V. The venous system of the pelvis: new nomenclature. Phlebology. 2010 Aug;25(4):162-73. doi: 10.1258/phleb.2010.010006
- Geier B, Barbera L, Mumme A, Köster O, Marpea B, Kaminsky C, Asciutto G. Reflux patterns in the ovarian and hypogastric veins in patients with varicose veins and signs of pelvic venous incompetence. Chir Ital. 2007 Jul-Aug;59(4):481-88.
Kiev, Verkhnaya Str., 5,
Scientific and Practical Center
For Preventive and Clinical Medicine,
Scientific Department of Minimally Invasive Surgery,
Oleh I. Nabolotnyi
Nabolotnyi Oleh I., Junior Researcher of the Scientific Department of Minimally Invasive Surgery, Scientific and Practical Center for Preventive and Clinical Medicine, Kiev, Ukraine.
Hupalo Yrii M., PhD, Leading Researcher of the Scientific Department of Minimally Invasive Surgery, Scientific and Practical Center for Preventive and Clinical Medicine, Kiev, Ukraine.
Shved Olena E., PhD, Senior Researcher of the Scientific Department of Minimally Invasive Surgery, Scientific and Practical Center for Preventive and Clinical Medicine, Kiev, Ukraine.
Gurianov Vitaly G., PhD, Associate Professor, Senior Researcher of the Scientific Departments of Medical Care Organization, Scientific and Practical Center for Preventive and Clinical Medicine, Kiev, Ukraine.