Investigation and treatment of pelvic vein reflux associated with varicose veins: Current views and practice of 100 UK vascular specialists.

Abstract

Management of pelvic vein disorders possibly contributing to leg varicose veins remains variable and controversial. This survey investigated practice in the UK. Email questionnaire to 328 members of the Vascular Society. One hundred and four (32%) questionnaires were returned. Of 100 respondents treating varicose veins, 9% do not recognise pelvic vein reflux and 11% never investigate or treat it. Indications for investigation include labial (94%) and buttock/upper thigh (70%) varicose veins: 46% use magnetic resonance venography and only 16% transvaginal duplex. Treatments used are coil embolization (89%), sclerotherapy via thigh veins (47%) and transcatheter sclerotherapy (26%). Thirty-four per cent treat only ovarian veins (not internal iliac tributaries). Follow-up is by clinical response (100%): only 14% use duplex. Only 5% treat >10 patients annually. There is substantial variation in the management of pelvic vein reflux in the UK. There is need for further consensus and good clinical trial evidence to guide practice.