Abstract
Pelvic congestion syndrome remains a poorly understood entity whose existence, let alone appropriate methods of investigation and treatment, are still under legitimate question. It is important that any endovascular therapist contemplating ovarian vein embolization works closely with a gynecologist, not only to ensure that other causes of pelvic pain are excluded, but to share in the considerable post procedure needs of these patients. Pelvic congestion syndrome is increasingly being diagnosed both clinically and by imaging in patients with pelvic pain. Referral patterns are changing to include women being screened for lower extremity venous insufficiency. Although there is a striking consistency to the clinical improvement achieved by ovarian vein embolization by multiple authors, it is necessary that any physician undertaking this procedure convey the controversial nature of the syndrome to the patient. Improvement in pain symptoms should be expected in 80–90 % of patients with significant improvement in 60 %. Treatment appears durable at 5-year follow-up. There remains considerable variation in the endovascular approach, and the optimum approach remains to be proven.
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Beard RW, Highman JD, Pearce S, Reginald PW (1984) Diagnosis of pelvic varicosities in women with chronic pelvic pain. Lancet 2:946–949
Carpasso P, Simons C et al (1997) Treatment of symptomatic pelvic varices by ovarian vein embolization. Cardiovasc Intervent Radiol 20:107–111
Cheong Y, Stones RW (2006) Chronic pelvic pain: aetiology and therapy. Best Pract Res Clin Obstet Gynaecol 20:695–711
Chung MH, Huh CY (2003) Comparison of treatments for pelvic congestion syndrome. Tohoku J Exp Med 201:131–138
Coakley FV, Varghese SL et al (1999) CT and MRI of pelvic varices in women. J Comput Assist Tomogr 23:429–434
Edwards RD, Robertson IR, MacLean AB, Hemingway AP (1993) Case report: pelvic pain syndrome—successful treatment of a case by ovarian vein embolization. Clin Radiol 47:429–431
Gandini R, Chiocchi M, Konda D, Pampana E, Fabiano S, Simonetti G (2008) Transcatheter foam sclerotherapy of symptomatic female varicocele with sodium-tetradecyl-sulfate foam. Cardiovasc Intervent Radiol 31:778–784
Gloviczki P, Comerota AJ et al (2011) The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 53(5 Suppl):2S–48S
Harris K, Mehta S, Ishakov E et al (2012) Ovarian vein thrombosis in the nonpregnant woman: an overlooked diagnosis. Ther Adv Hematol 3(5):325–328
Hodgkinson CP (1953) Physiology of ovarian veins during pregnancy. Obstet Gynecol 1:26–37
Jung SC, Lee W, Chung JW et al (2009) Unusual causes of varicose veins in the lower extremities: CT venographic and Doppler US findings. Radiographics 29:525–536
Kim HS, Malhotra AD, Rowe PC, Lee JM, Venbrux AC (2006) Embolotherapy for pelvic congestion syndrome: long-term results. J Vasc Interv Radiol 17:289–297
Kuligowska E, Deeds L et al (2005) Pelvic pain: overlooked and underdiagnosed gynecologic conditions. Radiographics 25:3–20
Kwon SH, Oh JH, Ko KR, Park HC, Huh JY (2007) Transcatheter ovarian vein embolization using coils for the treatment of pelvic congestion syndrome. Cardiovasc Intervent Radiol 30:655–661
Laborda A, Medrano J, de Blas I, Urtiaga I, Carnevale FC, de Gregorio MA (2013) Endovascular treatment of pelvic congestion syndrome: visual analog scale (VAS) long-term follow-up clinical evaluation in 202 patients. Cardiovasc Intervent Radiol 3:1006–1014
Rozenblit AM, Ricci ZJ et al (2001) Incompetent and dilated ovarian veins: A common CT finding in asymptomatic parous women. AJR 176:119–122
Venbrux AC, Chang AH et al (2002) Pelvic congestion syndrome (pelvic venous incompetence): impact of ovarian and internal iliac vein embolotherapy on menstrual cycle and chronic pelvic pain. J Vasc Interv Radiol 13:171–178
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© 2014 Springer Berlin Heidelberg
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Machan, L. (2014). Embolization in Pelvic Congestion Syndrome. In: Reidy, J., Hacking, N., McLucas, B. (eds) Radiological Interventions in Obstetrics and Gynaecology. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2014_974
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DOI: https://doi.org/10.1007/174_2014_974
Publisher Name: Springer, Berlin, Heidelberg
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