These include thrombophlebitis, embolization of nontarget vessels, recurrence varices, and stroke-related paradoxical emboli. Postembolization abdominal discomfort was reported in up to 14.8% of patients and is usually self-limited or treated with analgesic or anti-inflammatory medications [57]. Although success rates are favorable, excluding other causes such as nutcracker syndrome are important. Additionally, no randomized or high-quality controlled trials have been recorded, which limits the provided evidence. Though no gynecological complications were noted in the above literature, they have not been explicitly studied. No current prospective studies or randomized control trials demonstrating benefit of embolization for patients with pelvic-origin lower extremity varicose veins have been published. Current literature is limited to single-center case series which have failed to demonstrate significant improvement after pelvic venous embolization or stenting [52]. Overall, in distinction to ovarian vein embolization for patients with chronic pelvic pain, there is little evidence to support the use of embolization or stenting to aid in lower extremity pelvic origin varicose veins [52]. Conservative Management There is no relevant literature regarding the use of compression therapy in the treatment of pelvic-origin lower extremity varicose veins in women. Conservative therapies to manage symptoms of pelvic origin lower extremity varicose veins include compression therapy, nonsteroidal anti-inflammatory drugs, hormonal agents, ergot alkaloid derivatives, and venoactive agents [72]. Variant 7: Suspected iliocaval or lower extremity disease with severe post-thrombotic changes. Initial diagnosis. Catheter Venography Iliac Veins Catheter-directed venography of the iliac veins has been described as a diagnostic technique but is often now only performed as part of procedure with the intent to treat an iliocaval lesion.
Lower Extremity Chronic Venous Disease. These include thrombophlebitis, embolization of nontarget vessels, recurrence varices, and stroke-related paradoxical emboli. Postembolization abdominal discomfort was reported in up to 14.8% of patients and is usually self-limited or treated with analgesic or anti-inflammatory medications [57]. Although success rates are favorable, excluding other causes such as nutcracker syndrome are important. Additionally, no randomized or high-quality controlled trials have been recorded, which limits the provided evidence. Though no gynecological complications were noted in the above literature, they have not been explicitly studied. No current prospective studies or randomized control trials demonstrating benefit of embolization for patients with pelvic-origin lower extremity varicose veins have been published. Current literature is limited to single-center case series which have failed to demonstrate significant improvement after pelvic venous embolization or stenting [52]. Overall, in distinction to ovarian vein embolization for patients with chronic pelvic pain, there is little evidence to support the use of embolization or stenting to aid in lower extremity pelvic origin varicose veins [52]. Conservative Management There is no relevant literature regarding the use of compression therapy in the treatment of pelvic-origin lower extremity varicose veins in women. Conservative therapies to manage symptoms of pelvic origin lower extremity varicose veins include compression therapy, nonsteroidal anti-inflammatory drugs, hormonal agents, ergot alkaloid derivatives, and venoactive agents [72]. Variant 7: Suspected iliocaval or lower extremity disease with severe post-thrombotic changes. Initial diagnosis. Catheter Venography Iliac Veins Catheter-directed venography of the iliac veins has been described as a diagnostic technique but is often now only performed as part of procedure with the intent to treat an iliocaval lesion.