Bottom up Treatment for Vulvar and Lower Extremity Varicose Veins of Pelvic Origin: A Case Report

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE

EJVES Vascular Forum Pub Date : 2025-01-01 DOI:10.1016/j.ejvsvf.2024.12.004

Aleksandra Jaworucka-Kaczorowska , Marianne De Maeseneer

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Abstract

Background

Extrapelvic varices of pelvic origin, such as vulvar varices, and lower extremity varicose veins (VVs) of pelvic origin are being diagnosed with increasing frequency. A proper management strategy, including history, physical examination, duplex ultrasound (DUS) of the lower extremities, DUS of pelvic escape points, selection of appropriate treatment, and post-treatment care, is essential for good patient outcomes and satisfaction.

Case report

A non-pregnant, 27 year old female presented with prominent vulvar varices in combination with right sided VVs on the anterior and medial thigh, calf, and buttock. She was successfully managed by bottom up treatment with ultrasound guided foam sclerotherapy. The bottom up technique involves treatment of VVs of pelvic origin by direct puncture of the pelvic escape points and associated VVs, without embolisation of the pelvic veins.

Conclusion

This case illustrates successful bottom up treatment in accordance with recent guidelines in a female patient with extensive VVs of pelvic origin.

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自下而上治疗盆腔源性外阴下肢静脉曲张1例

背景：骨盆源的骨盆曲张，如外阴静脉曲张和下肢盆腔静脉曲张（VVs）的诊断频率越来越高。适当的治疗策略，包括病史、体格检查、下肢双超声（DUS）、骨盆逃逸点双超声（DUS）、选择适当的治疗方法和治疗后护理，对于良好的患者预后和满意度至关重要。病例报告：一名未怀孕的27岁女性，表现为外阴静脉曲张突出，并在大腿前部和内侧、小腿和臀部出现右侧静脉曲张。经超声引导泡沫硬化治疗，自下而上治疗成功。由下而上的技术包括通过直接穿刺骨盆逃逸点和相关的静脉来治疗盆腔起源的静脉，而不栓塞盆腔静脉。结论：本病例说明了根据最近的指导方针，成功的自下而上治疗盆腔起源广泛VVs的女性患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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