Efficiency of embolization with vascular plug and coils in pelvic venous insufficiency treatment

Purpose : To compare and exhibit the clinical efficiency of two different endovascular treatment techniques ( mechanical / mechanical+ chemical ) in patients diagnosed with pelvic venous congestion syndrome (PVCS). Material and Method : Between October 2012 and December 2013, 101 patients were considered as having pelvic venous insufficiency (PVI) via clinical evaluation and computed tomography imaging. All of them were underwent venography and 91 patients, who were treated by endovascular ovarian vein embolization using mechanical ( coil and/or vascular plug ) or mechanical + chemical (sclerotherapy) embolization, enrolled to the study. A questionnaire, measured by Visual Analog Scale (VAS), questioning 9 items and recommended by Society of Interventional Radiology was used to evaluate clinical respnse. VAS scores were recorded before and 3, 6, 12 months after the procedure. Results : Of those 91 patients; ovarian vein embolization was performed bilaterally in 41, only left in 38 and only right in 12. Total VAS score median value of the patients decreased to 8 from 35 (p<0.0001). Clinical improvement was detected in 97.9% of the patients and the rest 2.1% of them were clinically stable. There was no statistically significant difference between mechanical and mechanical+ chemical embolization with respect to clinical improvement. Statistically significant reduction was determined in disease specific symptoms. Any major complication related with the procedure was not developed. Conclusions : Endovascular treatment of PVI in patients with PVCS is an effective treatment method. Mechanical embolization should be the preferred technique in endovascular treatment options due to the lower complication rates.