Treatment of Symptomatic High-Flow Female Varicocele with Balloon-occluded Retrograde Transvenous Foam Sclerotherapy (B-ORTFS) Using Sodium-tetradecyl-sulphate Foam

Congress:

ECR 2013

Poster Number:

C-0800

Type:

Scientific Exhibit

Keywords:

Vascular, Veins / Vena cava, Genital / Reproductive system male, Fluoroscopy, CT-Angiography, Embolisation, Sclerosis, Varices

Authors:

R. Gandini, D. Konda, M. Chiocchi, E. Pampana, D. Morosetti, A. Chiaravalloti, G. Loreni, G. Simonetti; Rome/IT

DOI:

10.1594/ecr2013/C-0800

DOI-Link:

https://dx.doi.org/10.1594/ecr2013/C-0800

Fig. 1: Figure 1: Selectively left ovarian venography demonstrating a type II d pelvic...

Fig. 2: Figure 2: Right ovarian venography demonstrating a type IIa pelvic varicocele...

Fig. 3: Figure 3: Selectively left ovarian venography demonstrating a type I high-flow...

Table 1: Table 1. Patient population.

Purpose

Pelvic Congestion Syndrome (PCS), also known aspelvic pain syndrome and pelvic venous incompetence,is characterized by non-cyclic chronic pelvic with a duration of more than 6 months associated with the presence of ovarian or pelvic varices. This condition usually affectsmultiparous young women of childbearing age and can be potentially debilitating. The most common symptoms are pelvic pain of variable intensity and duration that can be associated todysmenorrhea,dyspareunia, post-coital pain and bladder irritability . Pain can extend to leg and can be worsened by walking or postural...

Methods and Materials

Patients A retrospective study was conducted in 12 consecutive patients (mean age: 35.2 years; range: 23-46) with PCS with atypical high-flow venous collaterals demonstrated during ovarian venography, treated at our Department by B-ORTFS between June 2005 and May 2008. Full approval and waiver of informed consent for our retrospective study was obtained by our institutional review board. Each patient gave written informed consent prior to the procedure. Patient population Patients were referred for treatment by gynecologists after a diagnosis of PCS had been made by...

Results

Pelvic varicocele B-ORTFS A technical success was achieved in all patients. A colic-like pain occurred after the injection of sclerosing agent with spontaneous resolution after 5 minutes in two (40%) patients. No other complications were observed. Mean fluoroscopy time was 23.4 minutes ± 3.91. Follow-up No recurrences of PCS were observed during the 12 month follow-up period. A substantial reduction in size of the pelvic varices with no signs of blood flow was observed at the 3, 6 and 12-month control color-Doppler US. SSS assessed...

Conclusion

To our knowledge, this is the first reported series of pelvic varicocele with high-flow collaterals treated by B-ORTFS. Our preliminary results need to be confirmed by studies including larger patient populations. Treatment of PCS with high-flow venous collaterals by B-ORTFS is a safe and effective and should be taken in consideration as an alternative to other endovascular and surgical options.

References

1 Hyun S. Kim, MD, Amit D. Malhotra, MD, Peter C. Rowe, MD, Judy M. Lee, MD, MPH, and Anthony C. Venbrux, MD. Embolotherapy for Pelvic Congestion Syndrome: Long-term Results. J Vasc Interv Radiol 2006;17:289–297 2 Edwards RD, Robertson JR, MacLean AB, et al. Case report: pelvic pain syndrome – successful treatment of a case by ovarian vein embolization. Clin Radiol 1993;47:429-431 3Eclavea A. Pelvic congestion syndrome: multicenter results.J Vasc Intervent Radiol 1998; 9:184–185 4Gandini R, Chiocchi M, Konda D, Pampana E, Fabiano S, Simonetti...