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1.
Ratnam LA Marsh P Holdstock JM Harrison CS Hussain FF Whiteley MS Lopez A 《Cardiovascular and interventional radiology》2008,31(6):1159-1164
Pelvic vein incompetence is common in patients with atypical varicose veins, contributing to their recurrence after surgery.
Therefore, refluxing pelvic veins should be identified and treated. We present our experience with pelvic vein embolisation
in patients presenting with varicose veins. Patients presenting with varicose veins with a duplex-proven contribution from
perivulval veins undergo transvaginal duplex sonography (TVUS) to identify refluxing pelvic veins. Those with positive scans
undergo embolisation before surgical treatment of their lower limb varicose veins. A total of 218 women (mean age of 46.3 years)
were treated. Parity was documented in the first 60 patients, of whom 47 (78.3%) were multiparous, 11 (18.3%) had had one
previous pregnancy, and 2 (3.3%) were nulliparous. The left ovarian vein was embolised in 78%, the right internal iliac in
64.7%, the left internal iliac in 56.4%, and the right ovarian vein in 42.2% of patients. At follow-up TVUS, mild reflux only
was seen in 16, marked persistent reflux in 6, and new reflux in 3 patients. These 9 women underwent successful repeat embolisation.
Two patients experienced pulmonary embolisation of the coils, of whom 1 was asymptomatic and 1 was successfully retrieved;
1 patient had a misplaced coil protruding into the common femoral vein; and 1 patient had perineal thrombophlebitis. The results
of our study showed that pelvic venous embolisation by way of a transjugular approach is a safe and effective technique in
the treatment of pelvic vein reflux. 相似文献
2.
Purpose To evaluate the therapeutic effectiveness of ovarian vein embolization using coils for pelvic congestion syndrome (PCS), a
common cause of chronic pelvic pain in multiparous women.
Methods Between November 1998 and June 2005, 67 patients were diagnosed with PCS and underwent ovarian vein coil embolization. Through
medical records and telephone interviews, the pre-embolization pain level and post-embolization pain control were assessed.
In addition, in those cases where pain persisted after embolization or where patients were dissatisfied with the procedure,
additional treatments and subsequent changes in pain scores were also analyzed. Evaluation after coil embolization was performed
within 3–6 months (n = 3), 6 months to 1 year (n = 7), 1–2 years (n = 13), 2–3 years (n = 7), 3–4 years (n = 7), 4–5 years (n = 13), or 5–6 years (n = 17).
Results Among a total of 67 patients, 82% (55/67) experienced pain reduction after coil embolization, were satisfied with the procedure,
and did not pursue any further treatment. Twelve patients (18%, 12/67) responded that their pain level had not changed, or
had become more severe. Among them, 9 patients were treated surgically and the remaining 3 patients remained under continuous
drug therapy.
Conclusion Ovarian vein embolization using coils is a safe and effective therapeutic method for treatment of PCS. It is thought that
surgical treatment should be considered in cases where embolization proves ineffective. 相似文献