State-of-the-Art Endovascular Management of Venous Diseases

Ali F. Hello everyone
If we have a patient with congestive pelvic syndrome (Symptomatic,lower abdominal heaviness at afternoon, dysparonia,...)
MRV shows nutcracker radiologic finding (asymptomatic, no flank pain no hematuria)
And shows also significant reflux in the left ovarian vein with hudge intrapelvic varicosiries
How do you manage this patient
Do u treat nutcracker or not,first?
Do u treat left ovarian vein only?

Mehmet M. I eill prefer to treat only left ovarian vein by coil embolization.
Nutcracker treatment is more complicated and usually not necessary

Guillermo M. Patient with symptomatic Nutcracker. Severe stenosis of left renal vein. Reflux on left gonadal vein wich is enlarged (9 mm). After embolization of LGV the patient suffers a worsening of her symptoms. What would you make, open surgery or stenting

Mangesh T. Dear Dr.Houmann Sir, Again great presentation on Embolisation in PCS And Deep Venous Stenting; But do you follow the newer “SVP Classification” for Pelvic Venous disorders and plan your Endovascular IR treatment accordingly??

Which will you address first “Venous Reflux or Obstruction” to normalise increased Pelvic Venous Pressure and how much is your overall Technical Success rates??