ABSTRACT
We have reported a case of a 36-year-old woman with flank and pelvic pain and hematuria. She had posterior nutcracker syndrome and pelvic varices involving one anterior and three posterior renal veins (including one major vein). We used a complete endovascular approach, which included stent implantation in the major posterior renal vein and left gonadal vein embolization. During a 12-month follow-up period, the patient had had no symptoms and good computed tomography results. Endovascular treatment represents a safe and successful option for patients with nutcracker syndrome and pelvic varices involving the anterior and posterior renal veins.
ABSTRACT
BACKGROUND: Ultrasound-guided foam sclerotherapy (UGFS) for treatment of chronic venous insufficiency (CVI) has been attracting significant interest over the past 20 years. It is a minimally invasive technique that comprises a safe treatment option and has yielded good results, especially in cases of advanced disease, with high rates of wound healing. OBJECTIVE: To examine clinical, ultrasound, and photoplethysmography outcomes after a 1-year follow-up of UGFS for CVI. MATERIALS AND METHODS: Twenty-nine legs classified as C4, C5, or C6 of the CEAP classification were included. Patients answered the VEINES questionnaire on quality of life and symptoms. and their venous filling time (VFT) was measured using photoplethysmography before and 45, 180, and 360 days after treatment of CVI with UGFS. RESULTS: The results showed statistically significant improvements in VEINES quality-of-life and symptom scores and in VFT measured by photoplethysmography and a reduction in great saphenous vein diameter (p < .0001) at 45, 180, and 360 days after treatment with UGFS. CONCLUSION: Ultrasound-guided foam sclerotherapy demonstrated efficacy and resulted in high satisfaction levels, confirmed by improvement in questionnaire scores, venous refilling time, and ultrasound findings.