Pelvic congestion syndrome is one of the many causes of chronic pelvic pain and is often diagnosed based on exclusion of other pathologies. Over the past decades, pelvic congestion syndrome was recognized to be a more common cause of chronic pelvic pain. Multiple diagnostic modalities including pelvic duplex ultrasonography, transvaginal ultrasonography, computed tomography, and magnetic resonance were studied. In the current literature, selective ovarian venography, an invasive imaging approach, is believed to be the gold standard for diagnosing pelvic congestion syndrome.

Objective: The purpose of this study was to evaluate potential factors affecting patient non-compliance after endovascular aneurysm repair. Method: We performed a retrospective review of patients undergoing elective or emergency endovascular repair for thoracic, abdominal aorta, or iliac artery aneurysm at a single institution from November 2007 to March 2014. Compliance to follow-up at 1, 6, and 12 months was assessed. Factors evaluated included patient demographics, size of aneurysm, distance between the patient’s residence and outpatient clinic, urgency of surgery, and time of year in which the follow-up visits were scheduled. Results: During the study period, 205 patients (75% male and 25% female) fulfilled the inclusion criteria. One-month mortality was 1.1% for elective procedures and 16.1% for emergency procedures (p = 0.001). Overall mortality at 12 months was 6.3% and 32.3% for elective and emergency procedures, respectively (p = 0.0002). Highest compliance was observed at 1 month, with 184 patients (93%) attending. A significant decrease was seen at 6 (n = 102, 54%) and 12 (n = 89, 48%) months. At the 12-month mark, a larger proportion of minority patients were non-compliant compared with Caucasian patients. Confounders for non-compliance were analyzed using multivariate analysis, and statistical significance was found for widowed marital status (p = 0.008), travel distance >25 miles to the outpatient clinic (p = 0.032), and emergency repair of aneurysms (p = 0.022). Conclusion: Despite emphasizing the importance of follow-up after endovascular aortic procedures, almost half of the treated patients were non-compliant. Our study identified travel distance, marital status, and urgency of surgery as factors that may affect patients’ compliance to scheduled follow-up visits.

Background/Objectives: Calcified atherosclerotic disease of the common femoral artery (CFA) is a unique therapeutic challenge. Although endarterectomy has been the gold standard for CFA disease treatment, the evolution of endovascular techniques has led to increasing interest in minimally invasive alternatives to open surgery. Intravascular lithotripsy (IVL) offers calcium modification, facilitating vessel compliance and enhancing the effect of adjunctive therapies. Methods: A systematic review of current literature was conducted to summarize data on clinical outcomes and perioperative complications of IVL for the treatment of calcified CFA disease. Eligible studies up to July 2025 were included. Demographics, procedural and follow-up data were extracted and analyzed. Results: A total of 304 patients across 9 studies were included. The majority of the patients were males (68%) with hypertension (88%), dyslipidemia (75%) and smoking history (65%). Of the included patients, 56% had chronic limb-threatening ischemia (CLTI), with a previous intervention reported in about one-third of them. Additional calcium-modifying technology was used at the discretion of the operator in 11% of cases. The overall dissection rate was 2% (95% confidence interval (CI): 0–6%) with only five cases having flow-limiting dissections. Stenting rate was 3% (95% CI: 0–11%). No perforations or distal embolization events were reported by the rest of the studies apart from one study that had one such case. The overall periprocedural complication rate was 5% (95% CI: 0–13%). The 12-month target lesion revascularization (TLR) rate was 9% (95% CI: 3–18%). Conclusions: IVL could be a safe alternative endovascular option to open repair for treating calcified CFA disease with low rates of procedural complications. Further studies are needed to clarify IVL’s role in clinical practice, particularly for patients who are poor candidates for open surgery.