BASIC ANATOMY
Pelvic veins and lower extremities veins form a functional unit resulting in the interaction of their pathology
 Kamina P, et al. Phlebologie 1989 isolated SCP with Superficial Chronic Venous Insufficiency (SCVI) Grading of PCS？imaging classification in practice → to plan procedure
Imaging classification in practice → to plan the procedure
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Thin-walled, unsupported veins
- Lack of valves (up to 16% on the left), even less in IIV (Ahlberg NE, et al. Acta Radiol Diagn 1966)
- Abnormalities in collagen
- hormonal and hemodynamic factor related to pregnancy
- smooth muscle layer in OV undergoes age related thinning - reduced contractility
-Venous outflow obstruction “nutcracker phenomenon"
-Pregnancy
-Pregnancy
-Gravity
-Upright position
三个因素都 Increase of intraluminal pressure
三个因素都 Increase of intraluminal pressure
Oklu R, et al. J Vasc Interv Radiol 2012
有人将盆腔静脉淤血按血流速度分为两型
Type I Low-flow pelvic varicocele 低速盆腔静脉曲张
a. Non-cross-pelvic. 非跨越盆腔
b. Cross-pelvic. 跨越盆腔
Type II High-flow pelvic varicocele 高速盆腔静脉曲张
a. Non-cross-pelvic (high-outflow through the ipsilateral hypogastric vein). 非跨越盆腔（通过同侧的髂静脉）
b. Cross-pelvic varicocele 跨越盆腔静脉曲张
1. High-outflow through the contralateral hypogastric vein. 通过对侧髂内静脉的高血流
2. High-outflow through both hypogastric veins. 双侧前内静脉高血流
3. High-outflow through the contralateral ovarian vein. 通过对侧卵巢静脉高血流
4. High-outflow through all of the above veins. 通过以上所有静脉的高血流
1. Adams et al., Br J Obstet Gyn 1990