Journal «Angiology and Vascular Surgery» • 

2019 • VOLUME 25 • №4

Endovascular treatment of women with pelvic varicose veins due to post-thrombotic iliac vein lesion

Akhmetzyanov R.V., Bredikhin R.A., Fomina E.E., Ignatyev I.M.

Interregional Clinical and Diagnostic Centre, Department of Cardiovascular and Endovascular Surgery, Kazan State Medical University of the RF Ministry of Public Health, Kazan, Russia

Background. Post-thrombotic iliac vein lesion is one of the causes of secondary pelvic varicose veins (PVV) in women. Endovascular treatment of this cohort of patients requires further studies.

Objective. The study was undertaken to investigate the aspects of endovascular treatment of female patients diagnosed as having PVV secondary to post-thrombotic alterations of the iliac veins.

Patients and methods. Presented herein are the results of diagnosis and treatment of nine women suffering from PVV in obstructive lesion of the iliac veins. All patients underwent phlebography with stenting of the iliac veins, followed by clinical and instrumental assessment of efficacy of treatment.

Results. The technical success rate of stenting amounted to 100%. In the early postoperative period thrombotic complications developed in two women and in the remote period in one. The operation was followed by a decrease in the intensity of PVV manifestations, as well as chronic venous insufficiency of the lower limbs, which was confirmed by clinical and instrumental methods of objectification and visualization. The composite index of quality of life was noted to decrease from 47±5.3 to 27.8±3.3 points (p<0.05). The median of the composite value of the Pelvic Venous Clinical Severity Score decreased by 8.6±1.8 points (p<0.05). The average value of the composite index of the Venous Clinical Severity Score (VCSS) diminished by 6.8±1.4 points (p<0.05) and that of the Villalta score by 8.3±1.6 points (p<0.05).

Conclusion. Pelvic varicose veins appear to develop in two of three women after endured thrombosis. The experience with stenting of the iliac veins demonstrated good efficacy and safety. Efficiency of the intervention was determined by improved quality of life of the patients and positive dynamics of the clinical course of the disease.

KEY WORDS: pelvic varicose veins, post-thrombotic disease, stenting of iliac veins, quality of life questionnaire, disease severity scale.

P. 99

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