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DOI: 10.1055/s-0042-1744214
Direct Fluoroscopic-Guided Sclerotherapy for Vulvoperineal Varices: An Experience in 70 Patients
Abstract
Purpose The aim of this study was to assess the safety and effectiveness of percutaneous vulvoperineal varices sclerotherapy using 2% polidocanol foam under fluoroscopic guidance.
Subjects and Methods This is a retrospective review of prospectively collected data of 70 patients treated between June 2020 and November 2021, with a mean age of 31 years (range: 24–42 years). All patients were not pregnant with residual vulvoperineal varices after embolization of their refluxing tributaries of the ovarian vein and/or internal iliac veins presenting with vulvoperineal heaviness/pain with or without lower limb varicosities. Technical and clinical successes together with procedural complications were assessed.
Results The technical success rate was 100%. No minor or major complications have been reported. Follow-up was at 1 week, 2 weeks, 6 months, and 12 months post sclerotherapy. Clinical success was observed in all patients with improvement in their symptoms.
Conclusion Direct fluoroscopic-guided sclerotherapy for vulvoperineal varices offers a safe and effective treatment option with the ability of visualization and embolization of the pelvic leak points to avoid recurrence.
Publikationsverlauf
Artikel online veröffentlicht:
20. April 2022
© 2022. The Pan Arab Interventional Radiology Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Johnson NR. Vulvovaginal varicosities and pelvic congestion syndrome. UpToDate. 2011 . Accessed February 10, 2022 at: https://www.uptodate.com/contents/vulvovaginal-varicosities-and-pelvic-congestion-syndrome
- 2 van Rij AM, Jiang P, Solomon C, Christie RA, Hill GB. Recurrence after varicose vein surgery: a prospective long-term clinical study with duplex ultrasound scanning and air plethysmography. J Vasc Surg 2003; 38 (05) 935-943
- 3 Van Cleef J-F. Treatment of vulvar and perineal varicose veins. Phlebolymphology 2011; 18 (01) 38-43
- 4 Winokur RS. The new vocabulary of pelvic venous disorders. Endovascular Today. 2021; 20 (04) 54-56
- 5 Rozenblit AM, Ricci ZJ, Tuvia J, Amis Jr ES. Incompetent and dilated ovarian veins: a common CT finding in asymptomatic parous women. AJR Am J Roentgenol 2001; 176 (01) 119-122
- 6 Delfrate R, Bricchi M, Franceschi C. Minimally-invasive procedure for pelvic leak points in women. Veins and Lymphatics 2019; 8 (01) 7789
- 7 Zamboni P, Mendoza E, Gianesini S. Saphenous Vein-Sparing Strategies in Chronic Venous Diseases. Ferrara, Italy: Springer; 2018. ISBN: 978–3-319–70638–28
- 8 Thomas ML, Fletcher EWL, Andress MR. et al. The venous connections of vulval varices. Clin Radiol 1967; 18 (03) 313-317
- 9 Craig O, Hobbs JT. Vulval phlebography in the pelvic congestion syndrome. Clin Radiol 1975; 26 (04) 517-525
- 10 Paraskevas P. Successful ultrasound-guided foam sclerotherapy for vulval and leg varicosities secondary to ovarian vein reflux: a case study. Phlebology 2011; 26 (01) 29-31
- 11 Verma SB. Varicosities of vulva (vulvar varices): a seldom seen entity in dermatologic practice. Int J Dermatol 2012; 51 (01) 123-124
- 12 Lopez AJ. Female pelvic vein embolization: indications, techniques, and outcomes. Cardiovasc Intervent Radiol 2015; 38 (04) 806-820
- 13 Tessari L, Cavezzi A, Frullini A. Preliminary experience with a new sclerosing foam in the treatment of varicose veins. Dermatol Surg 2001; 27 (01) 58-60
- 14 Theresa M. Soto. Accessed December 10, 2021 at: Understanding-vulvar-varicosities. https://www.centerforvein.com/blog/
- 15 Franceschi C, Bahnini A. Leak points between pelvic viscera and lower limb varicosities. Phlebologie 2004; 57: 37-42
- 16 Francheschi C, Bahnini A. Treatment of lower extremity venous insufficiency due to pelvic leak points in women. Ann Vasc Surg 2005; 19 (02) 284-288
- 17 Hobbs JT. The pelvic congestion syndrome. Br J Hosp Med 1990; 43 (03) 200-206
- 18 Maleux G, Stockx L, Wilms G, Marchal G. Ovarian vein embolization for the treatment of pelvic congestion syndrome: long-term technical and clinical results. J Vasc Interv Radiol 2000; 11 (07) 859-864
- 19 Nasser F, Cavalcante RN, Affonso BB, Messina ML, Carnevale FC, de Gregorio MA. Safety, efficacy, and prognostic factors in endovascular treatment of pelvic congestion syndrome. Int J Gynaecol Obstet 2014; 125 (01) 65-68
- 20 Kies DD, Kim HS. Pelvic congestion syndrome: a review of current diagnostic and minimally invasive treatment modalities. Phlebology 2012; 27 (Suppl. 01) 52-57
- 21 Gavrilov SG, Zolotukhin IA, Moskalenko EP, Turishcheva OO. Sclerotherapy of vulvar varicose veins. Flebologiia 2016; 10 (01) 50
- 22 Gavrilov SG. Vulvar varicosities: diagnosis, treatment, and prevention. Int J Womens Health 2017; 9: 463-475
- 23 Ninia JG, Goldberg TL. Treatment of vulvar varicosities by injection-compression sclerotherapy. Dermatol Surg 1997; 23 (07) 573-574 , discussion 574–575
- 24 Nabatoff RA. Varicose veins of pregnancy. JAMA 1960; 174: 1712-1716
- 25 Naous J, Siqueira L. A vulvovaginal mass in a 16-year-old adolescent: a case report. J Pediatr Adolesc Gynecol 2016; 29 (01) e17-e19
- 26 Zelikovski A, Sternberg A, Haddad M, Urca I. Varicosities of uncommon sites: therapeutic aspects. Int Surg 1981; 66 (01) 73-77