Amplatzer vascular plug for alternate treatment in pelvic congestive syndrome in Dr. Soetomo General Hospital: A case report
Main Article Content
Keywords
Pelvic congestive syndrome, Amplatzer Vascular Plug, Embolization
Abstract
Introduction: One of the common causes of chronic pelvic pain in reproductive-age women is pelvic congestion syndrome (PCS). This pain can be constant or intermittent for 3-6 months, occurring throughout the menstrual cycle, arising in the abdominal or pelvic area, and is not related to pregnancy. Complaints of chronic pelvic pain are as much as 10-20% of gynecological consultations, and only 40% of them are referred to specialists for evaluation. 10 – 60 % of PCS is caused by insufficient iliac vein, ovarica vein, or both. Incompetent ovarian vein ligation can head to a favorable result. An endovascular technique using an embolization coil, glue, foam, or amplatzer can be an alternative treatment for PCS.
Case Description : Women 50 years old whom a history of chronic pelvic pain, CT angiography showed Left ovarica vein dilatate and prominant. Durante operation, approach from a right femoral vein with a catheter to the left renal and ovarian veins. Amplatzer vascular plug was deployed at the left ovarian vein and evaluated. There wasn’t insufficient. The Patient was discharged the day after the operation.
Conclusion : In conclusion, venous occlusion with vascular plug for PCS management is safe and effective with an embolization agent or surgery with a significant enhancement in pelvic symptoms for PCS.
References
2. Daniels J, Gray R, Hills RK, Latthe P, Buckley L, Gupta J, Selman T, Adey E, Xiong T, Champaneria R, Lilford R, Khan KS., LUNA Trial Collaboration. Laparoscopic uterosacral nerve ablation for alleviating chronic pelvic pain: a randomized controlled trial. JAMA. 2009 Sep 02;302(9):955-61
3. Beard RW, Reginald PW, Wadsworth J. Clinical features of women with chronic lower abdominal pain and pelvic congestion. Br J Obstet Gynaecol. 1988 Feb;95(2):153-61.
4. Bittles MA, Hoffer EK. Gonadal vein embolization: treatment of varicocele and pelvic congestion syndrome. Semin Intervent Radiol. 2008 Sep;25(3):261-70
5. Meissner MH, Gibson K. Clinical outcome after treatment of pelvic congestion syndrome: sense and nonsense. Phlebology 2015; 30(1 suppl):73–80
6. Gloviczki P, Comerota AJ, Dalsing MC, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 2011; 53(5 suppl):2S–48S.
7. A Randomized Trial of Endovascular Embolization Treatment in Pelvic Congestion Syndrome: Fibered Platinum Coils versus Vascular Plugs with 1-Year Clinical Outcomes Guirola, Jose A. et al. Journal of Vascular and Interventional Radiology, Volume 29, Issue 1, 45 – 53
8. Cheong YC, Smotra G, Williams AC. Non-surgical interventions for the management of chronic pelvic pain. Cochrane Database Syst Rev. 2014 Mar 05;(3):CD008797.
9. Antignani PL, Lazarashvili Z, Monedero JL, Ezpeleta SZ, Whiteley MS, Khilnani NM, et al.. Diagnosis and treatment of pelvic congestion syndrome: UIP consensus document. Int Angiol.(2019) 38:265–83. 10.23736/S0392-9590.19.04237-8
10. Senechal Q, Echegut P, Bravetti M, Florin M, Jarboui L, Bouaboua M, Teriitehau C, Feignoux J, Legou F, Pessis E. Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale Follow-Up. Front Cardiovasc Med. 2021 Nov 17;8:751178. doi: 10.3389/fcvm.2021.751178. PMID: 34869656; PMCID: PMC8635860.
11. Yamasaki W, Kakizawa H, Ishikawa M, et al. Migration to the pulmonary artery of nine metallic coils placed in the internal iliac vein for treatment of giant rectal varices. Acta Radiol Short Rep. 2012;1(6):1–4.
12. Bittles MA, Hoffer EK. Gonadal vein embolization: treatment of varicocele and pelvic congestion syndrome. Semin Intervent Radiol. 2008;25(3):261–270. doi: 10.1055/s-0028-1085927
13. Chung MH, Huh CY. Comparison of treatments for pelvic congestion syndrome. Tohoku J Exp Med. 2003;201(3):131–138. doi: 10.1620/tjem.201.131
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.