Ovarian vein embolization for the treatment of pelvic congestion syndrome: long-term technical and clinical results.
OBJECTIVE
Ovarian vein embolization has been used recently to treat pelvic congestion syndrome. The purpose of this study is to evaluate the clinical efficacy and safety of ovarian vein embolization in the treatment of symptomatic pelvic varices.


METHODS
We performed ovarian vein embolization in 41 patients (mean age, 37.8 years; range, 30-58 years): 32 patients underwent unilateral embolization and nine patients underwent bilateral embolization. All had lower abdominal pain and pelvic varicosities were found on retrograde ovarian vein venography. Embolization was performed with a mixture of enbucrilate and lipiodized oil in all but one patient, in whom enbucrilate and minicoils were used. Initial technical success rate and clinical follow-up (1-61 months; mean, 19.9 months), conducted with use of mailed questionnaires, are reported.


RESULTS
Initial technical success rate was 98%. Immediate complications were noted in two patients (4%) in the form of migration of some fragments of glue (used as embolic agent), which was treated conservatively. Clinical follow-up reveals variable symptomatic relief in 9.7% of cases and a total relief of symptoms in 58.5% of cases. Results in patients who had insufficient ovarian veins bilaterally were no better than those in patients for whom only the left ovarian vein was found insufficient.


CONCLUSIONS
Transcatheter embolization of the ovarian veins is a safe and feasible technique leading to complete relief of symptoms in more than half of cases. No statistically significant difference in clinical outcome could be noted between patients presenting with bilateral insufficient ovarian veins, who underwent bilateral embolization, and patients presenting with an insufficient left ovarian vein, who underwent left unilateral embolization.
Department of Radiology, University Hospitals, Leuven, Belgium. geert.maleux@uz.kuleuven.ac.be
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G
Maleux
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L
Stockx
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Wilms
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Marchal
D015746:Abdominal Pain / Q000628:therapy; D000328:Adult; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004659:Enbucrilate / Q000627:therapeutic use; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D007459:Iodized Oil; D008875:Middle Aged; D008904:Miniaturization; D010053:Ovary / Q000098:blood supply*; D017699:Pelvic Pain / Q000628:therapy; D010388:Pelvis / Q000098:blood supply*; D010690:Phlebography; D012449:Safety; D013577:Syndrome; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome; D014648:Varicose Veins / Q000628:therapy*; D014680:Veins
D003287:Contrast Media; D014014:Tissue Adhesives; D007459:Iodized Oil; D004659:Enbucrilate