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Abstract

Klippel-Trenaunay syndrome (KTS) is a rare congenital malformation involving blood and lymph vessels and abnormal growth of soft and bone tissue. Typical symptoms include hemangiomas (abnormal benign growths on the skin consisting of masses of blood vessels) and varicose veins. year-old patient with Klippel's Syndrome in treatment since 2017, with pain worsening for 50 days in the lumbar region, EVN10 pain, no relief, nocturnal worsening making it impossible to sleep, band pain, continuous, throbbing. Patient under drug treatment without remission and adequate pain control. It presents asymmetry of limbs with shortening of the lower limb. Complex regional syndrome in the left lower limb with venous malformations, alteration of phaneros, alteration of temperature in relation to the right limb, edema, muscle trophy and bone alterations. We performed the intervention with the aim of diagnosing pain due to adjacent vascular changes and also as a clinical treatment for pain control. Due to the painful condition and vascular alterations, specific material was requested to perform the procedure safely. A new interventional block technique was studied to perform the block in the lumbar region with a specific cannula and microscopy attached to the cannula tip associated with ultrasound, thus avoiding vascular lesions, minimizing risks. An endoscopic ultrasound technique was then performed to block the bilateral lumbosacral plexus, quadratus lumborum and erector spinae. Soon after performed pulsed radiofrequency 42 degrees 120 seconds 2 cycles with the aim of neuromodulation and reduction of inflammatory activity. The procedure lasted one hour, and the patient was discharged within 24 hours with complete remission of pain.

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