[A post-thrombotic pelvic congestion syndrome]

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Gynecology

Background:

• Pelvic congestion syndrome (PCS) is a chronic pelvic pain condition associated with pelvic varices.
• PCS can arise from primary venous insufficiency or secondary to venous obstruction.

Observation:

• A 35-year-old patient with extensive left iliac vein thrombosis developed disabling PCS.
• The patient was treated with left iliac vein recanalization and stenting.
• Combined antithrombotic therapy (aspirin and rivaroxaban) followed by antiplatelet therapy led to symptom resolution.

Findings:

• Iliac vein stenting and antithrombotic therapy effectively managed PCS secondary to post-thrombotic lesions.
• Complete and lasting symptom regression was achieved in the reported case.

Implications:

• Management of PCS secondary to post-thrombotic lesions requires consideration of its pathophysiology.
• Iliac venous angioplasty with stenting and antithrombotic therapy is a promising treatment approach.
• Further long-term follow-up studies are needed to define optimal antithrombotic modalities.