Group of Research in Minimally Invasive Techniques Research (GITMI), University of Zaragoza, Zaragoza, Spain.
Cardiovasc Intervent Radiol. 2013 Aug;36(4):1006-14. doi: 10.1007/s00270-013-0586-2. Epub 2013 Mar 2.
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.
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.
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 < 0.0001). Complications were: groin hematoma (n = 6), coil migration (n = 4), and reaction to contrast media (n = 1). Twenty-three cases presented abdominal pain after procedure. In 24 patients (12.5%), there was recurrence of their leg varices within the follow-up. The mean degree of patients' satisfaction was 7.4/9.
Coil embolization of PCS is an effective and safe procedure, with high clinical success rate and degree of satisfaction.
本研究旨在评估 202 例因下肢静脉功能不全初诊而接受慢性盆腔痛患者的盆腔静脉淤血综合征（PCS）线圈栓塞治疗后 5 年的临床疗效和患者满意度。
在一家单中心前瞻性招募了 202 例慢性盆腔痛患者（平均年龄 43.5 岁；范围 27-57 岁），这些患者正在接受下肢静脉曲张的治疗。纳入标准为：下肢静脉曲张和慢性盆腔痛（>6 个月），超声检查盆腔静脉内径>6mm，静脉反流或交通静脉存在。均对卵巢静脉和髂内静脉进行栓塞。采用视觉模拟评分（VAS）评估栓塞治疗前后及随访期间的疼痛程度。研究了技术和临床成功率以及腿部静脉曲张的复发情况。患者完成了质量问卷。临床随访在 1、3、6 个月和第 5 年进行。
技术成功率为 100%。168 例（93.85%）患者获得临床成功，其中 60 例（33.52%）症状完全消失。疼痛评分（VAS）术前为 7.34±0.7，随访结束时为 0.78±1.2（P<0.0001）。并发症为：腹股沟血肿（n=6）、线圈迁移（n=4）和对比剂反应（n=1）。23 例患者在术后出现腹痛。在 24 例（12.5%）患者中，在随访期间腿部静脉曲张复发。患者满意度平均为 7.4/9。
PCS 线圈栓塞是一种有效且安全的方法，具有较高的临床成功率和满意度。
