Minimally Invasive Treatment Offers Relief for Pelvic Venous Disease

Patient: Female, 63 years old
Date of Visit: One month after left iliac vein stenting
Procedure: Left common iliac vein angioplasty and stent placement following IVUS examination

Background:
The patient, Isla, experienced ongoing lower abdominal and pelvic pressure, discomfort and painful intercourse (dyspareunia). An intravascular ultrasound revealed a narrowing (84.6% area reduction) of her left common iliac vein caused by compression from the overlying right common iliac artery. This condition is known as May-Thurner syndrome, which can restrict blood flow and cause pelvic congestion symptoms.

Treatment:
Isla underwent a minimally invasive procedure where the narrowed vein was opened with a balloon (angioplasty), followed by placement of a stent to keep the vein open and restore normal blood flow.

Results (One Month After Procedure):
She reports complete resolution of pelvic discomfort and painful intercourse. Ultrasound shows the stent is widely open with no signs of blockage or narrowing. She is currently on anticoagulation therapy with Xarelto and aspirin, planning to transition to Xarelto and Plavix temporarily, then aspirin alone after the next imaging check in three months.

Plan Going Forward:
Isla will have follow-up ultrasounds at two months (for a final three-month scan), at nine months, one year and then annually for about four years to monitor stent health and symptom status.

Clinical Impression:
This case highlights successful treatment of pelvic congestion syndrome caused by May-Thurner syndrome, demonstrating full symptom relief and restored venous outflow in a patient with classic presentation but minimal leg symptoms.