Incapacitating Pelvic Congestion Syndrome in a Patient With a History of May-Thurner Syndrome and Left Ovarian Vein Embolization

In the setting of a combined diagnosis of PCS and May-Thurner syndrome, persistent incapacitating PCS after initial iliac stenting should be followed with a complete pelvic venous evaluation including ovarian and left renal venography to rule out residual pelvic congestion secondary to any coexisting ovarian vein incompetencies or nutcracker syndrome.