ILIAC VENOUS STENTING PROVIDES LONG TERM RELIEF FROM CHRONIC PELVIC PAIN

Abstract

ObjectiveIliac Venous Obstruction (IVO) has been reported as a cause of chronic pelvic pain (CPP), however , there is a paucity of data in the literature reporting outcomes of venous stenting in this population. This study reports on a group of women with CPP and evidence of IVO: i) the long-term impact of iliac vein stenting on pain scores; ii) the associations of age, stenosis severity, and concurrent presence of ovarian vein reflux (OVR) on pain ; and iii) the effect of pregnancy post stenting. MethodsRetrospective analysis of prospectively collected data of women with chronic pelvic pain who subsequently underwent iliac vein stenting. Data analysed included demographics, venous measures (iliac and ovarian veins), visual analogue scales, and pregnancy post-stenting. ResultsA total of 113 female patients who had a history of chronic pelvic pain and underwent iliac venous stenting were included in analyses. Mean age at the time of stenting was 46.5 ± 15.7 years (range: 17 - 88 years). Baseline LCIV diameter on duplex was 0.43 ± 0.18 cm and LCIV area stenosis on IVUS was 77.4 ± 9.4%. Baseline pain severity was correlated with younger age, degree of stenosis and presence of OVR. At a median follow-up of 5 years post-stenting, 98% had improved pain scores, and 73% had complete resolution of their pain despite the presence of residual OVR . Pregnancy post-stenting did not result in recurrence of pain and there were no stent-related complications with pregnancy. ConclusionIliac venous stenting provides long term relief from CPP even with residual OVR and post-stent pregnancy. With 73% of women having full pain resolution, and the rest having a mean residual pain score of less than 3 , this study supports venous stenting for the treatment of CPP of venous origin, especially young women.