Dabbs Emma, Nemchand Jaya L, Whiteley Mark S
The Whiteley Clinic, Guildford, UK.
Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
SAGE Open Med Case Rep. 2017 Aug 8;5:2050313X17724712. doi: 10.1177/2050313X17724712. eCollection 2017.
Suprapubic varicose veins are usually indicative of unilateral iliac vein occlusion and venous collateralisation. We report two cases of suprapubic varicose veins following pelvic vein embolisation and subsequent pregnancy; both presented without residual pelvic venous reflux or pelvic venous obstruction. In both cases, there was no significant flow in the suprapubic veins indicating that they were not acting as a collateral post-pregnancy. One patient had this venous abnormality treated successfully with TRansluminal Occlusion of Perforators, followed by foam sclerotherapy to the main part of the suprapubic vein. This patient has since completed the reminder of her lower limb varicose vein treatment. We suggest that pregnancy may have caused prolonged intermittent compression of the left common iliac vein, and that this, together with the physiological impact of previous embolisation procedures, obstructed venous drainage from the left leg resulting in collateral vein formation within the 9-month gestation period.
耻骨上静脉曲张通常提示单侧髂静脉闭塞和静脉侧支循环形成。我们报告两例盆腔静脉栓塞后妊娠出现耻骨上静脉曲张的病例；两例均无残余盆腔静脉反流或盆腔静脉梗阻。两例耻骨上静脉均无明显血流，表明它们在妊娠后并非作为侧支血管发挥作用。其中一例患者经经皮腔内穿通支闭塞术成功治疗该静脉异常，随后对耻骨上静脉主干进行泡沫硬化治疗。该患者此后完成了下肢静脉曲张的后续治疗。我们认为，妊娠可能导致左髂总静脉长期间歇性受压，再加上先前栓塞手术的生理影响，阻碍了左腿的静脉引流，导致在9个月的妊娠期内形成侧支静脉。
