ORIGINAL ARTICLE   

Acta Phlebologica 2018 December;19(3):80-6

DOI: 10.23736/S1593-232X.18.00417-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Pelvic congestion syndrome as a predisposing factor of “two-level” varicose veins development

Larysa CHERNUKHA ¹ ✉, Alla GUCH ², Vadym KONDRATYUK ³, Olenka VLASENKO ³, Alla BOBROVA ¹

¹ Department of Surgery of Major Vessels, National Institute of Surgery and Transplantology, Kyiv, Ukraine; ² Department of Radiation and Functional Diagnostics, National Institute of Surgery and Transplantology, Kyiv, Ukraine; ³ Department of Angiography and Endovascular Surgery, National Institute of Surgery and Transplantology, Kyiv, Ukraine

BACKGROUND: Improvement of treatment results in patients with recurrent varicose veins (RVV) of the lower limbs in which the cause of RVV was pelvic congestion syndrome.
METHODS: We have experience in treatment of 285 patients with RVV of lower limbs operated in various medical institutions (2012-2017). In 23 (8.07%) patients, blood reflux from pelvic veins caused the lower limbs’ RVV, in 17 (5.96%) patients combination of lower limbs’ RVV and pelvic congestion syndrome (PCS) was detected. Patients underwent color duplex scanning, transvaginal ultrasound, diagnostic phlebography, computed tomography. Gynecological and gastroenterological pathology was excluded.
RESULTS: Ultrasonic signs of pelvic venous insufficiency were convoluted pelvic veins ≥4 mm, dilated ovarian veins ≥8 mm, reverse blood flow during the Valsalva test. Insufficiency of ovarian veins’ valves, presence of perineum and labia varicose veins were combined with saphenous vein system varicosities in 17 patients (75.16%) from 23. Five patients underwent endovenous obliteration of the left ovarian vein, two had laser ablation, three had radiofrequency ablation, combined with polidocanol in foam form (6-10 mL).
CONCLUSIONS: In 17 (5.96%) patients from total amount of 285 patients with RVV combination of lower limbs’ RVV and PCS was detected. Elimination of reflux is possible after elimination of venous reflux in the ovarian vein. Endovenous treatment may be used not only in elimination of the reflux in subcutaneous veins, but also in ovarian veins.

KEY WORDS: Varicose veins - Lower extremity - Embolization, therapeutic