title: Endovascular treatment of pelvic congestion syndrome: visual analog scale (VAS) long-term follow-up clinical evaluation in 202 patients.
abstract: OBJECTIVE
  This study was designed to evaluate the clinical outcome and patients' satisfaction after a 5 year follow-up period for pelvic congestion syndrome (PCS) coil embolization in patients who suffered from chronic pelvic pain that initially consulted for lower limb venous insufficiency.
  
  
  METHODS
  A total of 202 patients suffering from chronic pelvic pain were recruited prospectively in a single center (mean age 43.5 years; range 27-57) where they were being treated for lower limb varices. Inclusion criteria were: lower limb varices and chronic pelvic pain (>6 months), >6 mm pelvic venous caliber in ultrasonography, and venous reflux or presence of communicating veins. Both ovarian and hypogastric veins were targeted for embolization. Pain level was assessed before and after embolotherapy and during follow-up using a visual analog scale (VAS). Technical and clinical success and recurrence of leg varices were studied. Patients completed a quality questionnaire. Clinical follow-up was performed at 1, 3, and 6 months and every year for 5 years.
  
  
  RESULTS
  Technical success was 100%. Clinical success was achieved in 168 patients (93.85%), with complete disappearance of symptoms in 60 patients (33.52%). Pain score (VAS) was 7.34 ± 0.7 preprocedural versus 0.78 ± 1.2 at the end of follow-up (P < 0.0001). Complications were: groin hematoma (n = 6), coil migration (n = 4), and reaction to contrast media (n = 1). Twenty-three cases presented abdominal pain after procedure. In 24 patients (12.5%), there was recurrence of their leg varices within the follow-up. The mean degree of patients' satisfaction was 7.4/9.
  
  
  CONCLUSIONS
  Coil embolization of PCS is an effective and safe procedure, with high clinical success rate and degree of satisfaction.
authors: Group of Research in Minimally Invasive Techniques Research (GITMI), University of Zaragoza, Zaragoza, Spain. alaborda@unizar.es
authors: Alicia
authors: A
authors: Laborda
authors: Joaquin
authors: J
authors: Medrano
authors: Ignacio
authors: I
authors: de Blas
authors: Ignacio
authors: I
authors: Urtiaga
authors: Francisco Cesar
authors: FC
authors: Carnevale
authors: Miguel A
authors: MA
authors: de Gregorio
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply; D008875:Middle Aged; D010147:Pain Measurement; D017699:Pelvic Pain / Q000175:diagnosis* / Q000628:therapy*; D010690:Phlebography / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013577:Syndrome; D013997:Time Factors; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000175:diagnosis / Q000628:therapy*