Endovascular treatment of sciatic pain from venous congestion in the pelvis

Submitted: 23 November 2023
Accepted: 14 December 2023
Published: 15 December 2023
Abstract Views: 271
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Authors

Klippel-Trénaunay Syndrome (KTS) is a vascular disorder characterized by a combination of vascular malformations (capillary, lymphatic, and venous) and limb overgrowth. Pelvis involvement is less frequent and is often underrecognized. We report a case of a patient affected by KTS with persistent sciatic pain. Phlebography demonstrated significant pelvic venous congestion mainly due to reflux at the level of the sacral plexus venous. A minimally invasive approach was successfully utilized to treat reflux with complete pain regression.

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Citations

Sunderkrishnan R. Genetics of Klippel-Trenaunay-Weber Syndrome. 2022. Medscape Available from: https://emedicine.medscape.com/article/945760-overview?form=fpf
Alwalid O, Makamure J, Cheng QG, et al. Radiological Aspect of Klippel-Trénaunay Syndrome: A Case Series With Review of Literature. Curr Med Sci. 2018;38:925-31. DOI: https://doi.org/10.1007/s11596-018-1964-4
Wang SK, Drucker NA, Gupta AK, et al. Diagnosis and management of the venous malformations of Klippel-Trénaunay syndrome. J Vasc Surg Venous Lymphat Disord. 2017;5:587-95. DOI: https://doi.org/10.1016/j.jvsv.2016.10.084
John PR. Klippel-Trenaunay Syndrome. Tech Vasc Interv Radiol. 2019;22:100634. DOI: https://doi.org/10.1016/j.tvir.2019.100634
Liu NF, Lu Q, Yan ZX. Lymphatic malformation is a common component of Klippel-Trenaunay syndrome. J Vasc Surg. 2010;52:1557-63. DOI: https://doi.org/10.1016/j.jvs.2010.06.166
Wang H, Xie C, Lin W, et al. Internal Iliac Vein Reflux: An Underrecognized Pathophysiology in Klippel-Trénaunay Syndrome With Pelvis Involvement. Cureus. 2022;14:21472.
Lee A, Driscoll D, Gloviczki P, et al. Evaluation and management of pain in patients with Klippel-Trenaunay syndrome: a review. Pediatrics. 2005;115:744-9. DOI: https://doi.org/10.1542/peds.2004-0446
Meirer R, Huemer GM, Shafighi M, et al. Sciatic nerve enlargement in the Klippel-Trenaunay-Weber syndrome. Br J Plast Surg. 2005 ;58:565-8. DOI: https://doi.org/10.1016/j.bjps.2004.11.005
Burrows PE. Vascular malformations involving the female pelvis. Semin Intervent Radiol. 2008;25:347-60. DOI: https://doi.org/10.1055/s-0028-1102993
Noel AA, Gloviczki P, Cherry KJ Jr, et al. Surgical treatment of venous malformations in Klippel-Trénaunay syndrome. J Vasc Surg. 2000;32:840-7. DOI: https://doi.org/10.1067/mva.2000.110343
Servelle M. Klippel and Trénaunay's syndrome. 768 operated cases. Ann Surg. 1985;201:365-73. DOI: https://doi.org/10.1097/00000658-198503000-00020
Cucinella G, Di Buono G, Geraci G, et al. Uterine Involvement in Klippel-Trenaunay Syndrome: A Rare But Relevant Event. Review of the Literature. Front Surg. 2022;9:893320. DOI: https://doi.org/10.3389/fsurg.2022.893320
De Gregorio MA, Guirola JA, Alvarez-Arranz E, et al. Pelvic venous disorders in women due to pelvic varices: treatment by embolization: experience in 520 patients. J Vasc Interv Radiol. 2020;31:1560-9. DOI: https://doi.org/10.1016/j.jvir.2020.06.017
Tessari L, Cavezzi A, Frullini A. Preliminary experience with a new sclerosing foam in the treatment of varicose veins. Dermatol Surg. 2001;27:58-60. DOI: https://doi.org/10.1097/00042728-200101000-00017
Gloviczki P, Comerota AJ, Dalsing MC, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53:2S-48S. DOI: https://doi.org/10.1016/j.jvs.2011.01.079
Senechal Q, Echegut P, Bravetti M, et al. Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale Follow-Up. Frontiers in Cardiovascular Medicine. 2021;8:751178. DOI: https://doi.org/10.3389/fcvm.2021.751178
Wang H, Xie C, Lin W, et al. Internal Iliac Vein Reflux: An Underrecognized Pathophysiology in Klippel-Trénaunay Syndrome With Pelvis Involvement. Cureus. 2022;14:e21472. DOI: https://doi.org/10.7759/cureus.21472
Berthelot JM, Douane F, Ploteau S, et al. Venous congestion as a central mechanism of radiculopathies. Joint Bone Spine. 2022;89:105291. DOI: https://doi.org/10.1016/j.jbspin.2021.105291
Labropoulos N, Tiongson J, Pryor L, et al. Nonsaphenous superficial vein reflux. J Vasc Surg. 2001;34:872-7. DOI: https://doi.org/10.1067/mva.2001.118813
Hallan DR, McNutt S, Reiter GT, et al. Dilated Epidural Venous Plexus Causing Radiculopathy: A Report of 2 Cases and Review of the Literature. World Neurosurg. 2020;144:231-7. DOI: https://doi.org/10.1016/j.wneu.2020.09.036
Ahmed K, Sampath R, Khan MS. Current trends in the diagnosis and management of renal nutcracker syndrome: a review. Eur J Vasc Endovasc Surg. 2006;31:410-6. DOI: https://doi.org/10.1016/j.ejvs.2005.05.045
White JM, Comerota AJ. Venous Compression Syndromes. Vasc Endovascular Surg. 2017;51:155-68. DOI: https://doi.org/10.1177/1538574417697208
Lemos N, Cancelliere L, Li ALK, et al. Superior gluteal vein syndrome: an intrapelvic cause of sciatica. J Hip Preserv Surg. 2019;6:104-8. DOI: https://doi.org/10.1093/jhps/hnz012
Possover M, Forman A. Pelvic Neuralgias by Neuro-Vascular Entrapment: Anatomical Findings in a Series of 97 Consecutive Patients Treated by Laparoscopic Nerve Decompression. Pain Physician. 2015;18:E1139-43. DOI: https://doi.org/10.36076/ppj.2015/18/E1139
Ricci S, Georgiev M, Jawien A, Zamboni P. Sciatic nerve varices. Eur J Vasc Endovasc Surg. 2005;29:83-7. DOI: https://doi.org/10.1016/j.ejvs.2004.09.009

How to Cite

Bressan, M., Massi, I., Tsolaki, E., & Galeotti, R. (2023). Endovascular treatment of sciatic pain from venous congestion in the pelvis. Veins and Lymphatics, 12(1). https://doi.org/10.4081/vl.2023.12124