Abstract:

Article presents our experience of endovascular occlusion of gonadal veins in patients with pelvic congestion syndrome (PCS). Interventional treatment of patients with this pathology requires further research.

Aim: was to study aspects of endovascular occlusion of gonadal veins in patients with pelvic congestion syndrome.

Materials and methods: 22 patients with a primary form of pelvic congestion syndrome were included in a prospective, single-center study. The diagnosis was based on screening ultrasound duplex angioscanning. The criterion for inclusion in the study was the presence of varicose expansion of ovarian veins (OV) of more than 5 mm in combination with its valve failure. Exclusion criteria were: presence of secondary PCS against the background of obstructive syndromes, multivessel anatomy type of OV, pregnancy at any gestation age.

To assess the dynamics of manifestations of pelvic venous congestion, we used the PVVQ questionnaire (Pelvic Varicose Veins Questionnaire) and the PCS clinical severity scale - PVCSS (Pelvic Venous Clinical Severity Score), as well as the visual-analogue scale (VAS) of main symptoms of the disease.

Instrumental research methods included: ultrasound duplex transvaginal and transabdominal angioscanning (UDAS), multispiral computer phlebography (MSCT-phlebography), digital phlebography with invasive direct phlebomanometry.

Results: technical success of endovascular occlusion of ovarian veins was 100%. In two cases, immediately after the operation, a second intervention was performed: in one case - resection of the ovarian vein, in the second - re-positioning of the microspiral. In the long-term follow-up period, in one of the women due to relapse, the ovarian vein occlusion procedure was repeated.

Conclusions: estimation of results of clinical research methods, showed a decrease in the intensity of manifestations of pelvic congestion syndrome basing on severity scale and a visual-analogue scale, as well as an improvement in the quality of life of patients.

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Abstract:

Aim. Was to demonstrate our experience of using the stent-assistant technology for treatment of thromboembolic complication during endovascular procedures in extra- and intracranial arteries.

Materials and methods. Five patients with thromboembolic complication were successfully treated using stent-assistant technology In one case thromboembolic complication appeared during stenting of ICA, another - during performing of diagnostic cerebral angiography In 3 cases thromboembolic complications appeared during endovascular occlusion of intracranial artery. In four cases we used stent Solitaire (Covidien) in one case - Enterprise (Codman).

Results. In all cases we achieved full restoration of blood flow in intracranial vessels. Three patients were discharged without any neurological deficit. Two patients were discharged with minimal neurological deficit (mRS 1).

Conclusion. Stent-assistant technology can be successfully used in treatment of thromboembolic complications during endovascular procedures in extra- and intracranial arteries.

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