Bottom up Treatment for Vulvar and Lower Extremity Varicose Veins of Pelvic Origin: A Case Report

Background: Extrapelvic varices of pelvic origin, such as vulvar varices, and lower extremity varicose veins (VVs) of pelvic origin are being diagnosed with increasing frequency. A proper management strategy, including history, physical examination, duplex ultrasound (DUS) of the lower extremities,...

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Main Authors: Aleksandra Jaworucka-Kaczorowska, Marianne De Maeseneer
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:EJVES Vascular Forum
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666688X24001618
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author Aleksandra Jaworucka-Kaczorowska
Marianne De Maeseneer
author_facet Aleksandra Jaworucka-Kaczorowska
Marianne De Maeseneer
author_sort Aleksandra Jaworucka-Kaczorowska
collection DOAJ
description Background: Extrapelvic varices of pelvic origin, such as vulvar varices, and lower extremity varicose veins (VVs) of pelvic origin are being diagnosed with increasing frequency. A proper management strategy, including history, physical examination, duplex ultrasound (DUS) of the lower extremities, DUS of pelvic escape points, selection of appropriate treatment, and post-treatment care, is essential for good patient outcomes and satisfaction. Case report: A non-pregnant, 27 year old female presented with prominent vulvar varices in combination with right sided VVs on the anterior and medial thigh, calf, and buttock. She was successfully managed by bottom up treatment with ultrasound guided foam sclerotherapy. The bottom up technique involves treatment of VVs of pelvic origin by direct puncture of the pelvic escape points and associated VVs, without embolisation of the pelvic veins. Conclusion: This case illustrates successful bottom up treatment in accordance with recent guidelines in a female patient with extensive VVs of pelvic origin.
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issn 2666-688X
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publishDate 2025-01-01
publisher Elsevier
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series EJVES Vascular Forum
spelling doaj-art-9d9b57c9d6844fb4b26d251bdb54bc9c2025-08-20T03:23:06ZengElsevierEJVES Vascular Forum2666-688X2025-01-0163535610.1016/j.ejvsvf.2024.12.004Bottom up Treatment for Vulvar and Lower Extremity Varicose Veins of Pelvic Origin: A Case ReportAleksandra Jaworucka-Kaczorowska0Marianne De Maeseneer1Centre of Phlebology and Aesthetic Medicine, Gorzów Wlkp., Poland; Corresponding author. Centre of Phlebology and Aesthetic Medicine, Plac Jana Pawła II 76 CD, 66-400 Gorzów Wlkp., Poland.Department of Dermatology, Erasmus Medical Centre, Rotterdam, the NetherlandsBackground: Extrapelvic varices of pelvic origin, such as vulvar varices, and lower extremity varicose veins (VVs) of pelvic origin are being diagnosed with increasing frequency. A proper management strategy, including history, physical examination, duplex ultrasound (DUS) of the lower extremities, DUS of pelvic escape points, selection of appropriate treatment, and post-treatment care, is essential for good patient outcomes and satisfaction. Case report: A non-pregnant, 27 year old female presented with prominent vulvar varices in combination with right sided VVs on the anterior and medial thigh, calf, and buttock. She was successfully managed by bottom up treatment with ultrasound guided foam sclerotherapy. The bottom up technique involves treatment of VVs of pelvic origin by direct puncture of the pelvic escape points and associated VVs, without embolisation of the pelvic veins. Conclusion: This case illustrates successful bottom up treatment in accordance with recent guidelines in a female patient with extensive VVs of pelvic origin.http://www.sciencedirect.com/science/article/pii/S2666688X24001618Bottom up treatmentPelvic escape pointsPelvic vein incompetencePelvic venous disordersUltrasound guided foam sclerotherapyVulvar varicose veins
spellingShingle Aleksandra Jaworucka-Kaczorowska
Marianne De Maeseneer
Bottom up Treatment for Vulvar and Lower Extremity Varicose Veins of Pelvic Origin: A Case Report
EJVES Vascular Forum
Bottom up treatment
Pelvic escape points
Pelvic vein incompetence
Pelvic venous disorders
Ultrasound guided foam sclerotherapy
Vulvar varicose veins
title Bottom up Treatment for Vulvar and Lower Extremity Varicose Veins of Pelvic Origin: A Case Report
title_full Bottom up Treatment for Vulvar and Lower Extremity Varicose Veins of Pelvic Origin: A Case Report
title_fullStr Bottom up Treatment for Vulvar and Lower Extremity Varicose Veins of Pelvic Origin: A Case Report
title_full_unstemmed Bottom up Treatment for Vulvar and Lower Extremity Varicose Veins of Pelvic Origin: A Case Report
title_short Bottom up Treatment for Vulvar and Lower Extremity Varicose Veins of Pelvic Origin: A Case Report
title_sort bottom up treatment for vulvar and lower extremity varicose veins of pelvic origin a case report
topic Bottom up treatment
Pelvic escape points
Pelvic vein incompetence
Pelvic venous disorders
Ultrasound guided foam sclerotherapy
Vulvar varicose veins
url http://www.sciencedirect.com/science/article/pii/S2666688X24001618
work_keys_str_mv AT aleksandrajaworuckakaczorowska bottomuptreatmentforvulvarandlowerextremityvaricoseveinsofpelvicoriginacasereport
AT mariannedemaeseneer bottomuptreatmentforvulvarandlowerextremityvaricoseveinsofpelvicoriginacasereport