Iliac venous stenting provides long-term relief from chronic pelvic pain

Iliac venous obstruction 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 iliac venous obstruction: (1) the long-term impact of iliac vein stenting on pain scores; (2) the associations of age, stenosis severity, and concurrent presence of ovarian vein reflux (OVR) on pain; and (3) the effect of pregnancy after stenting.

We conducted a retrospective analysis of prospectively collected data of women with chronic pelvic pain who subsequently underwent iliac vein stenting. Data analyzed included demographics, venous measures (iliac and ovarian veins), visual analog scales, and pregnancy after stenting.

A total of 113 female patients who had a history of chronic pelvic pain and underwent iliac venous stenting were included in analyses. The mean age at the time of stenting was 46.5 ± 15.7 years (range, 17-88 years). The baseline left common iliac vein diameter on duplex was 0.43 ± 0.18 cm and left common iliac vein area stenosis on intravascular ultrasound was 77.4 ± 9.4%. The baseline pain severity was correlated with younger age, degree of stenosis and presence of OVR. At a median follow-up of 5 years after stenting, 98% had improved pain scores and 73% had complete resolution of their pain despite the presence of residual OVR. Pregnancy after stenting did not result in the recurrence of pain and there were no stent-related complications with pregnancy.

Iliac venous stenting provides long-term relief from CPP even with residual OVR and poststent pregnancy. With 73% of women having full pain resolution, and the rest having a mean residual pain score of <3, this study supports venous stenting for the treatment of CPP of venous origin, especially in young women.