Vol 86, No 5 (2015)
ARTICLES
Evaluation of effectiveness of endovascular embolisation for the treatment of pelvic congestion syndrome – preliminary study
Krzysztof Pyra, Sławomir Woźniak, Tomasz Roman, Piotr Czuczwar, Agnieszka Trojanowska, Tomasz Jargiełło, Tomasz Paszkowski
DOI: 10.17772/gp/2420
·
Ginekol Pol 2015;86(5).
Vol 86, No 5 (2015)
ARTICLES
Abstract
Objectives: The Aim: The aim of the study was to evaluate the effectiveness, safety and clinical outcomes of
endovascular embolisation of pelvic congestion syndrome (PCS).
Material and methods: This prospective, observational study carried out between January and May of 2014
encompassed 24 female patients aged 22-44 years (average - 31 years) diagnosed with PCS. Diagnosis of PCS was
established by medical history, physical examination, transvaginal Doppler ultrasound examination and confirmed
by MRI. The patients were qualified for phlebography and ovarian vein embolization with 0.035” detachable coils
and/or microcoils. Pelvic pain scores were assessed before and 3 months after the procedure with the visual analog
scale (VAS; 0 – no pain, 10 – unbearable pain).
Results: Embolisation procedures were performed in 23 out of 24 patients. Nineteen patients underwent unilateral
and 4 patients bilateral embolisation of the ovarian vein. In one case, safe and selective vessel catheterization was
not possible due to the anatomical variant of venous flow. Nineteen patients underwent unilateral embolisation of
the left ovarian vein. Four patients had the left and right ovarian veins embolized; in one of them, the internal iliac
vein was additionally closed (the two-stage procedure). The technical success rate was 96%. Procedures lasted
23-78 minutes (32 minutes on average). An average of 40 ml of contrast was administered during the procedures.
The total mean radiation dose at the reference point was 389 mGy (from 127 mGy to 1112 mGy). A decrease in
pelvic pain intensity according to VAS was considered a clinical success. The median VAS pelvic pain score before
the procedure was 8. Three months after the procedure median pelvic pain score decreased to 1 (p < 0.001). In
two cases, the ovarian vein was injured and the contrast medium extravasated, which was clinically insignificant. In
one case, a small injection site haematoma developed.
Conclusion: Embolisation is a minimally invasive, effective and safe method of treatment for PCS. The cooperation
between gynaecologists and interventional radiologists is essential for successful outcomes.
Abstract
Objectives: The Aim: The aim of the study was to evaluate the effectiveness, safety and clinical outcomes of
endovascular embolisation of pelvic congestion syndrome (PCS).
Material and methods: This prospective, observational study carried out between January and May of 2014
encompassed 24 female patients aged 22-44 years (average - 31 years) diagnosed with PCS. Diagnosis of PCS was
established by medical history, physical examination, transvaginal Doppler ultrasound examination and confirmed
by MRI. The patients were qualified for phlebography and ovarian vein embolization with 0.035” detachable coils
and/or microcoils. Pelvic pain scores were assessed before and 3 months after the procedure with the visual analog
scale (VAS; 0 – no pain, 10 – unbearable pain).
Results: Embolisation procedures were performed in 23 out of 24 patients. Nineteen patients underwent unilateral
and 4 patients bilateral embolisation of the ovarian vein. In one case, safe and selective vessel catheterization was
not possible due to the anatomical variant of venous flow. Nineteen patients underwent unilateral embolisation of
the left ovarian vein. Four patients had the left and right ovarian veins embolized; in one of them, the internal iliac
vein was additionally closed (the two-stage procedure). The technical success rate was 96%. Procedures lasted
23-78 minutes (32 minutes on average). An average of 40 ml of contrast was administered during the procedures.
The total mean radiation dose at the reference point was 389 mGy (from 127 mGy to 1112 mGy). A decrease in
pelvic pain intensity according to VAS was considered a clinical success. The median VAS pelvic pain score before
the procedure was 8. Three months after the procedure median pelvic pain score decreased to 1 (p < 0.001). In
two cases, the ovarian vein was injured and the contrast medium extravasated, which was clinically insignificant. In
one case, a small injection site haematoma developed.
Conclusion: Embolisation is a minimally invasive, effective and safe method of treatment for PCS. The cooperation
between gynaecologists and interventional radiologists is essential for successful outcomes.
Keywords
embolisation / pelvic congestion syndrome / ovarian vein embolisation
Title
Evaluation of effectiveness of endovascular embolisation for the treatment of pelvic congestion syndrome – preliminary study
Journal
Ginekologia Polska
Issue
Vol 86, No 5 (2015)
Page views
996
Article views/downloads
1066
DOI
10.17772/gp/2420
Bibliographic record
Ginekol Pol 2015;86(5).
Keywords
embolisation / pelvic congestion syndrome / ovarian vein embolisation
Authors
Krzysztof Pyra
Sławomir Woźniak
Tomasz Roman
Piotr Czuczwar
Agnieszka Trojanowska
Tomasz Jargiełło
Tomasz Paszkowski