TY - JOUR
T1 - Diagnosis and Management of Pelvic Venous Disorders
T2 - AJR Expert Panel Narrative Review
AU - Knuttinen, M. Grace
AU - Machan, Lindsay
AU - Khilnani, Neil M.
AU - Louie, Michelle
AU - Caridi, Theresa M.
AU - Gupta, Ramona
AU - Winokur, Ronald S.
N1 - Publisher Copyright:
© 2023 American Roentgen Ray Society. All rights reserved.
PY - 2023/11
Y1 - 2023/11
N2 - Pelvic venous disorders (PeVD), previously known by various imprecise terms including pelvic congestion syndrome, have historically been underdiagnosed as a cause of chronic pelvic pain (CPP), a significant health problem associated with reduced quality of life. However, progress in the field has helped to provide heightened clarity with respect to definitions relating to PeVD, and evolution in algorithms for PeVD workup and treatment has been accompanied by new insights into the causes of a pelvic venous reservoir and associated symptoms. Ovarian and pelvic vein embolization, as well as endovascular stenting of common iliac vein compression, should be considered as management options for PeVD. Both treatments have been shown to be safe and effective for patients with CPP of venous origin, regardless of age. Current therapeutic protocols for PeVD exhibit significant heterogeneity owing to limited prospective randomized data and evolving understanding of the factors driving successful outcomes; forthcoming clinical trials are anticipated to improve understanding of CPP of venous origin as well as algorithms for PeVD management. This Expert Panel Narrative Review provides a contemporary update relating to PeVD, summarizing the entity's current classification, diagnostic workup, endovascular treatments, management of persistent or recurrent symptoms, and future research directions.
AB - Pelvic venous disorders (PeVD), previously known by various imprecise terms including pelvic congestion syndrome, have historically been underdiagnosed as a cause of chronic pelvic pain (CPP), a significant health problem associated with reduced quality of life. However, progress in the field has helped to provide heightened clarity with respect to definitions relating to PeVD, and evolution in algorithms for PeVD workup and treatment has been accompanied by new insights into the causes of a pelvic venous reservoir and associated symptoms. Ovarian and pelvic vein embolization, as well as endovascular stenting of common iliac vein compression, should be considered as management options for PeVD. Both treatments have been shown to be safe and effective for patients with CPP of venous origin, regardless of age. Current therapeutic protocols for PeVD exhibit significant heterogeneity owing to limited prospective randomized data and evolving understanding of the factors driving successful outcomes; forthcoming clinical trials are anticipated to improve understanding of CPP of venous origin as well as algorithms for PeVD management. This Expert Panel Narrative Review provides a contemporary update relating to PeVD, summarizing the entity's current classification, diagnostic workup, endovascular treatments, management of persistent or recurrent symptoms, and future research directions.
KW - chronic pelvic pain
KW - endovascular embolization
KW - endovascular stenting
KW - left common iliac vein compression
KW - pelvic congestion syndrome
KW - pelvic venous disorders
UR - http://www.scopus.com/inward/record.url?scp=85175330923&partnerID=8YFLogxK
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U2 - 10.2214/AJR.22.28796
DO - 10.2214/AJR.22.28796
M3 - Article
C2 - 37095667
AN - SCOPUS:85175330923
SN - 0361-803X
VL - 225
SP - 565
EP - 574
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 5
ER -