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Diagnostics
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Diagnosis and Management of Pelvic Venous Diseases
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Diagnosis and Management of Pelvic Venous Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 April 2024 | Viewed by 9651

Special Issue Editor

Prof. Dr. Romaric Loffroy

E-Mail Website
Guest Editor
Department of Vascular, Oncologic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 14 Rue Gaffarel, BP 77908, CEDEX, 21079 Dijon, France
Interests: quantitative MRI of the liver; oncologic radiology; interventional radiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pelvic venous disorders mainly include male varicocele and female pelvic congestion syndrome (PCS), which are common diseases with high predominance in young patients and have a high impact on the quality of life and infertility. It also includes rarer obstructive pathologies such as May-Thurner syndrome or Nutcracker syndrome. Those diseases can lead to acute and chronic deep vein thrombosis or may be linked to peripheral vein disorders such as varicose veins and chronic venous insufficiency of the lower limbs. Different etiologies, risk factors, symptoms, imaging and diagnostic strategies, management, and preventive measures have been described. Recent advances in imaging techniques (doppler ultrasound, intravascular ultrasound, computed tomography, magnetic resonance imaging) and minimally invasive endovenous interventions (embolization, angioplasty, ablative techniques) may provide new insights in diagnosis and treatment of pelvic and peripheral venous diseases. It is important to better characterize pelvic venous diseases, define optimal imaging and treatment algorithms, and understand optimal strategies for management and follow-up of these patients. This Special Issue aims to publish original and/or review articles covering state-of-the-art imaging and endovascular techniques for the diagnosis and treatment of pelvic and peripheral venous diseases. We call for translational and clinical research aiming to improve knowledge in those objectives. Clinical and preclinical or experimental studies are all welcome.

Prof. Dr. Romaric Loffroy
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Pelvic venous disorders
  • Varicocele
  • Pelvic congestion syndrome
  • Varicose vein
  • Chronic venous insufficiency
  • Imaging
  • Ultrasound
  • Interventional radiology
  • Embolization

Published Papers (5 papers)

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Research

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9 pages, 401 KiB  
Article
May the Number of Pregnancies Predict the Progression and the Outcome of Venous Disease Treatment?
by Justyna Wilczko, Cezary Szary, Anna Bodziony, Krzysztof Celejewski, Siavash Swieczkowski-Feiz, Marcin Napierala, Dominika Plucinska, Jerzy Leszczynski, Michal Zawadzki and Tomasz Grzela
Diagnostics 2023, 13(15), 2535; https://doi.org/10.3390/diagnostics13152535 - 30 Jul 2023
Cited by 1 | Viewed by 691
Abstract
Pregnancy is a well-known risk factor for venous insufficiency. However, even nulliparous women experience venous problems. Therefore, we aimed to assess the possible associations between the number of pregnancies, veins condition and treatment outcome in women with venous disease. The retrospective assessment concerned [...] Read more.
Pregnancy is a well-known risk factor for venous insufficiency. However, even nulliparous women experience venous problems. Therefore, we aimed to assess the possible associations between the number of pregnancies, veins condition and treatment outcome in women with venous disease. The retrospective assessment concerned data of 297 women with diagnosed venous insufficiency. Based on their pregnancy history, the patients’ records were divided into: nulliparous women (15.5%), those after 1–2 term pregnancies (57.9%) and those after ≥3 pregnancies (26.6%). The analysis concerned data from the diagnostics of the abdominal/pelvic and leg veins and the treatment results expressed as a symptoms/satisfaction score. Most of the nulliparous women developed venous disease due to mild anatomic abnormalities of the abdominal/pelvic veins. They responded to treatment (mostly unilateral embolization) very well. In the second group, the majority of the combined venous abnormalities responded to treatment with significant improvement, even after embolization alone, although nearly two-thirds still required further leg treatment. The third group was comprised of more advanced cases; nearly 40% of them with recurrence. In order to improve their condition, three-fourths of the cases required sequential treatment in both the pelvic and leg veins compartments. In conclusion, the number of pregnancies is a potent modifying factor in the pathogenesis of venous disease, especially in multiparous women. Together with abnormal venous anatomy, it may determine the treatment outcome. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pelvic Venous Diseases)
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9 pages, 488 KiB  
Article
Does the Treatment of Pelvic Venous Insufficiency Really Not Influence Lower Limb Venous Disease?
by Cezary Szary, Justyna Wilczko, Anna Bodziony, Krzysztof Celejewski, Siavash Swieczkowski-Feiz, Marcin Napierala, Dominika Plucinska, Michal Zawadzki, Jerzy Leszczynski and Tomasz Grzela
Diagnostics 2023, 13(15), 2467; https://doi.org/10.3390/diagnostics13152467 - 25 Jul 2023
Cited by 2 | Viewed by 848
Abstract
Pelvic venous insufficiency is a common problem in multiparous women. Besides burdensome symptoms, it correlates with the development of venous disease in the lower limbs. Therefore, the sequential treatment of abdominal/pelvic before leg veins could improve treatment effectiveness. The medical records of 243 [...] Read more.
Pelvic venous insufficiency is a common problem in multiparous women. Besides burdensome symptoms, it correlates with the development of venous disease in the lower limbs. Therefore, the sequential treatment of abdominal/pelvic before leg veins could improve treatment effectiveness. The medical records of 243 patients with venous disease who were subjected to sequential treatment were analyzed retrospectively. The symptoms and patient satisfaction were assessed using dedicated questionnaires, both before and after treatment. Clinical effectiveness was verified using a Doppler scan, both before and after treatment. Among 243 analyzed cases, 195 underwent whole treatment; however, 48 women after embolization did not require further intervention. The total-symptom-score change (11.6 vs. 13.0, respectively) and the satisfaction score (1.6 vs. 1.5, respectively) did not differ between groups. After embolization, some patients, besides symptoms improvement, experienced reflux reduction and, hence, might avoid further intervention. A better explanation for this beneficial effect of the sequential/descending approach requires further studies. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pelvic Venous Diseases)
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13 pages, 3316 KiB  
Article
Cyanoacrylate Glue for Treating Chronic Saphenous Vein Insufficiency: A Retrospective Observational Single-Center Study
by Nicolas Falvo, Amine Latreche, Olivier Chevallier, Frédérik Ledan, Maud Jandot, Héla Daoud, Léo Fréchier and Romaric Loffroy
Diagnostics 2023, 13(14), 2313; https://doi.org/10.3390/diagnostics13142313 - 08 Jul 2023
Viewed by 1315
Abstract
Endovenous thermal methods are superseding surgical stripping for treating chronic superficial venous disease but require tumescent anesthesia and can cause heat-related nerve injuries. Endovenous cyanoacrylate ablation is a more recent technique that does not share these drawbacks. A retrospective observational study of consecutive [...] Read more.
Endovenous thermal methods are superseding surgical stripping for treating chronic superficial venous disease but require tumescent anesthesia and can cause heat-related nerve injuries. Endovenous cyanoacrylate ablation is a more recent technique that does not share these drawbacks. A retrospective observational study of consecutive adults managed with endovenous cyanoacrylate was conducted in 2018–2021 at a single university center. The follow-up was 18 months. We identified factors associated with target vein closure at 18 months and measured changes in quality of life using the generic 36-item Short-Form (SF-36) tool and the venous disease-specific VEINES-QOL/Sym questionnaire. Adverse events were collected. In the 55 study patients with 67 treated veins, the closure rate at 18 months was 94% (95% CI, 85–98%). Target vein diameter ≥9.5 mm had 81% sensitivity and 75% specificity for predicting recanalization. Quality-of-life scores improved significantly (p < 0.001 for both surveys). The only adverse event was a type IV allergic reaction to cyanoacrylate that was resolved with corticosteroid and histamine-antagonist therapy. Endovenous cyanoacrylate ablation was highly effective and is safe in experienced hands. Studies are warranted to determine whether changes in the protocol increase the closure rate in patients with target veins ≥9.5 mm in diameter. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pelvic Venous Diseases)
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9 pages, 974 KiB  
Article
Relationships of Pelvic Vein Diameter and Reflux with Clinical Manifestations of Pelvic Venous Disorder
by Sergey Gavrilov, Anatoly Karalkin, Nadezhda Mishakina, Oksana Efremova and Anastasia Grishenkova
Diagnostics 2022, 12(1), 145; https://doi.org/10.3390/diagnostics12010145 - 07 Jan 2022
Cited by 9 | Viewed by 1707
Abstract
The causes of chronic pelvic pain (CPP) in patients with pelvic venous disorder (PeVD) are not completely understood. Various authors consider dilation of pelvic veins (PeVs) and pelvic venous reflux (PVR) as the main mechanisms underlying symptomatic forms of PeVD. The aim of [...] Read more.
The causes of chronic pelvic pain (CPP) in patients with pelvic venous disorder (PeVD) are not completely understood. Various authors consider dilation of pelvic veins (PeVs) and pelvic venous reflux (PVR) as the main mechanisms underlying symptomatic forms of PeVD. The aim of this study was to assess relationships of pelvic vein dilation and PVR with clinical manifestations of PeVD. This non-randomized comparative cohort study included 80 female patients with PeVD who were allocated into two groups with symptomatic (n = 42) and asymptomatic (n = 38) forms of the disease. All patients underwent duplex scanning and single-photon emission computed tomography (SPECT) of PeVs with in vivo labeled red blood cells (RBCs). The PeV diameters, the presence, duration and pattern of PVR in the pelvic veins, as well as the coefficient of pelvic venous congestion (CPVC) were assessed. Two groups did not differ significantly in pelvic vein diameters (gonadal veins (GVs): 7.7 ± 1.3 vs. 8.5 ± 0.5 mm; parametrial veins (PVs): 9.8 ± 0.9 vs. 9.5 ± 0.9 mm; and uterine veins (UVs): 5.6 ± 0.2 vs. 5.5 ± 0.6 mm). Despite this, CPVC was significantly higher in symptomatic versus asymptomatic patients (1.9 ± 0.4 vs. 0.7 ± 0.2, respectively; p = 0.008). Symptomatic patients had type II or III PVR, while asymptomatic patients had type I PVR. The reflux duration was found to be significantly greater in symptomatic versus asymptomatic patients (median and interquartile range: 4.0 [3.0; 5.0] vs. 1.0 [0; 2.0] s for GVs, p = 0.008; 4.0 [3.0; 5.0] vs. 1.1 [1.0; 2.0] s for PVs, p = 0.007; and 2.0 [2.0; 3.0] vs. 1.0 [1.0; 2.0] s for UVs, p = 0.04). Linear correlation analysis revealed a strong positive relationship (Pearson’s r = 0.78; p = 0.007) of CPP with the PVR duration but not with vein diameter. The grade of PeV dilation may not be a determining factor in CPP development in patients with PeVD. The presence and duration of reflux in the pelvic veins were found to be predictors of the development of symptomatic PeVD. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pelvic Venous Diseases)
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Review

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12 pages, 6921 KiB  
Review
Diagnosis and Management of Pelvic Venous Disorders in Females
by Clément Marcelin, Yann Le Bras, Isabelle Molina Andreo, Eva Jambon and Nicolas Grenier
Diagnostics 2022, 12(10), 2337; https://doi.org/10.3390/diagnostics12102337 - 27 Sep 2022
Cited by 8 | Viewed by 3935
Abstract
Pelvic venous pathologies in females are responsible for chronic symptoms grouped under the term pelvic congestion syndrome, which includes chronic pelvic pain, perineal heaviness, urgency, and postcoital pain, along with vulvar, perineal, and lower limb varicose veins. These conditions are also associated with [...] Read more.
Pelvic venous pathologies in females are responsible for chronic symptoms grouped under the term pelvic congestion syndrome, which includes chronic pelvic pain, perineal heaviness, urgency, and postcoital pain, along with vulvar, perineal, and lower limb varicose veins. These conditions are also associated with ovarian and pelvic venous reflux and venous obstruction. This review aimed to explore the clinical and imaging modalities for diagnosing pelvic congestion syndrome, pelvic venous pathologies, their therapeutic management, and their outcomes. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pelvic Venous Diseases)
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: DIAGNOSTIC AND MANAGEMENT OF PELVIC VENOUS DISORDERS IN WOMEN
Authors: Le Bras, et al
Affiliation: Service d’Imagerie Diagnostique et Interventionnelle de l’adulte. CHU PELLEGRIN. BORDEAUX. France
Abstract: Pelvic venous pathologies in women are responsible for chronic symptoms grouped under the term pelvic congestion syndrome (PCS) which can include chronic pelvic pain, perineal heaviness, urgency and post-coital pain as well as vulvar varicose veins, perineal and / or lower limbs. They are linked to ovarian and / or pelvic venous reflux and / or venous obstruction. This article explores the clinical and imaging means for diagnosing pelvic congestion syndrome, pelvic venous pathologies, their therapeutic management and their results.

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