Rabe E, Pannier F
Department of Dermatology, University of Bonn, Bonn, Germany
Department of Dermatology, University of Cologne, Cologne and Private Practice Bonn, Bonn, Germany.
Phlebology. 2015 Mar;30(1 Suppl):86-8. doi: 10.1177/0268355515569412.
To consider if it is essential to perform embolization in the treatment of leg varices due to pelvic venous insufficiency.
Review of the current literature concerning treatment options of leg varicose veins of pelvic origin.
Pelvic venous insufficiency, vulvar and pudendal varicose veins as well as pelvic congestive syndrome are under diagnosed entities. Embolization of ovarian and pelvic veins is well established in patients with pelvic congestive syndrome. In varicose veins of pelvic origin but without pelvic congestive syndrome, comparative studies comparing the outcome of embolization or treatment of varicose veins by sclerotherapy or phlebectomy alone are missing. Foam sclerotherapy or phlebectomy shows good results in patients with varicose veins of pelvic origin.
Embolization is not essential in the treatment of leg varices of pelvic origin without pelvic congestive syndrome. Foam sclerotherapy or phlebectomy shows good results in patients with vulvar or pudendal varicose veins. Randomized comparative studies using embolization of incompetent pelvic veins or sclerotherapy of varicose veins with pelvic origin should be performed.
探讨在治疗盆腔静脉功能不全所致下肢静脉曲张时进行栓塞治疗是否必要。
回顾有关盆腔源性下肢静脉曲张治疗选择的当前文献。
盆腔静脉功能不全、外阴和阴部静脉曲张以及盆腔充血综合征是诊断不足的病症。卵巢和盆腔静脉栓塞在盆腔充血综合征患者中已得到充分确立。对于盆腔源性静脉曲张但无盆腔充血综合征的患者，缺乏比较栓塞治疗与单纯硬化疗法或静脉切除术治疗静脉曲张效果的研究。泡沫硬化疗法或静脉切除术在盆腔源性静脉曲张患者中显示出良好效果。
在治疗无盆腔充血综合征的盆腔源性下肢静脉曲张时，栓塞治疗并非必要。泡沫硬化疗法或静脉切除术在外阴或阴部静脉曲张患者中显示出良好效果。应进行使用盆腔功能不全静脉栓塞或盆腔源性静脉曲张硬化疗法的随机对照研究。
