Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale (VAS) Long-Term Follow-up Clinical Evaluation in 202 Patients

• Published in: Cardiovascular and interventional radiology 2013-08, Vol.36 (4), p.1006-1014
• Main Authors: Laborda, Alicia, Medrano, Joaquin, de Blas, Ignacio, Urtiaga, Ignacio, Carnevale, Francisco Cesar, de Gregorio, Miguel A.
• Format: Article
• Language: English
• Subjects: Adult; Cardiology; Chronic Pain - diagnosis; Chronic Pain - therapy; Clinical Investigation; Cohort Studies; CONTRAST MEDIA; Embolization, Therapeutic - methods; Endovascular Procedures - methods; EVALUATION; Female; Follow-Up Studies; HEMATOMAS; Humans; Imaging; INCLUSIONS; LEGS; Lower Extremity - blood supply; Medicine; Medicine & Public Health; Middle Aged; MIGRATION; Nuclear Medicine; PAIN; Pain Measurement; PATIENTS; Pelvic Pain - diagnosis; Pelvic Pain - therapy; Phlebography - methods; Prospective Studies; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Risk Assessment; Severity of Illness Index; Syndrome; Time Factors; Treatment Outcome; ULTRASONOGRAPHY; Ultrasound; VEINS; Venous Insufficiency - diagnosis; Venous Insufficiency - therapy
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-013-0586-2

Purpose This study was designed to evaluate the clinical outcome and patients’ satisfaction after a 5 year follow-up period for pelvic congestion syndrome (PCS) coil embolization in patients who suffered from chronic pelvic pain that initially consulted for lower limb venous insufficiency. Methods A total of 202 patients suffering from chronic pelvic pain were recruited prospectively in a single center (mean age 43.5 years; range 27–57) where they were being treated for lower limb varices. Inclusion criteria were: lower limb varices and chronic pelvic pain (>6 months), >6 mm pelvic venous caliber in ultrasonography, and venous reflux or presence of communicating veins. Both ovarian and hypogastric veins were targeted for embolization. Pain level was assessed before and after embolotherapy and during follow-up using a visual analog scale (VAS). Technical and clinical success and recurrence of leg varices were studied. Patients completed a quality questionnaire. Clinical follow-up was performed at 1, 3, and 6 months and every year for 5 years. Results Technical success was 100 %. Clinical success was achieved in 168 patients (93.85 %), with complete disappearance of symptoms in 60 patients (33.52 %). Pain score (VAS) was 7.34 ± 0.7 preprocedural versus 0.78 ± 1.2 at the end of follow-up ( P