经皮穿刺导管引导下泡沫硬化剂疗法治疗卵巢静脉曲张

目的 探讨导管引导下的泡沫硬化剂疗法治疗卵巢静脉曲张的临床效果.方法 选择2008至2009年间就诊于解放军总医院血管外科,诊断为卵巢静脉曲张的患者共13例,平均年龄39.4岁(31～52岁),病史1～20年不等,经皮穿刺导管引导左侧卵巢静脉主干内注射1%聚桂醇泡沫硬化剂,观察脉主干的闭合情况.结果 所有病例均在导管引导下成功注射硬化剂,平均应用泡沫硬化剂总量6.2 ml(4～ 9 ml).术后随访时间1～12个月(平均5.3个月),12例患者站立时盆腔坠胀不适感消失,1例减轻,5例性交痛2例消失,3例减轻,3例大腿内侧曲张静脉较前减轻,复查超声提示未见卵巢静脉主干,闭塞满意.结论 经皮穿刺导管引导的泡沫硬化剂疗法治疗卵巢静脉曲张主干闭合率较高,是微创治疗中一种有效的新方法.

Abstract：

Objective Foam sclerotherapy of ovarian varicocele is a relatively new and promising treatment option for patients with axial reflux. But its usefulness may be limited by low primary occlusion rates. Here a standard technique for catheter-directed foam sclerotherapy was presented to facilitate a precise delivery of foam to its intended site of action so as to potentially improve the occlusion rates. Methods A selective series of 13 females with ovarian varicocele were treated with foam sclerotherapy through a standard technique for foam delivery from 2008 to 2009. With a mean age 39.4 years, the patients were treated with 1% polidocanol foam through a catheter inserted percutaneously over a guidewire into the trunk of vena ovarica. All successfully treated patients were examined by colour duplex at 1 to 12 months post-procedure. Results Thirteen patients with an insufficiency reflux of vena ovarica were treated with catheter-directed foam sclerotherapy. Primary technical success was achieved in all patients. A dose of polidocanol 1.0% at 4-9 ml was administered. The mean follow-up period was 5.3 months. Pelvic cavity flatulency was totally released in 12 patients and 1 partially released. Two of 5 patients with algopareunia recovered and 3 with perineal region varicosis became relieved. On the follow-up ultrasonic examination, all trunks of vena ovarica became occluded. Conclusion This type of foam sclerotherapy is feasible with a high rate of primary occlusion.

Percutaneous puncture catheter-directed foam sclerotherapy of ovarian varicocele: report of preliminary results

Objective Foam sclerotherapy of ovarian varicocele is a relatively new and promising treatment option for patients with axial reflux. But its usefulness may be limited by low primary occlusion rates. Here a standard technique for catheter-directed foam sclerotherapy was presented to facilitate a precise delivery of foam to its intended site of action so as to potentially improve the occlusion rates. Methods A selective series of 13 females with ovarian varicocele were treated with foam sclerotherapy through a standard technique for foam delivery from 2008 to 2009. With a mean age 39.4 years, the patients were treated with 1% polidocanol foam through a catheter inserted percutaneously over a guidewire into the trunk of vena ovarica. All successfully treated patients were examined by colour duplex at 1 to 12 months post-procedure. Results Thirteen patients with an insufficiency reflux of vena ovarica were treated with catheter-directed foam sclerotherapy. Primary technical success was achieved in all patients. A dose of polidocanol 1.0% at 4-9 ml was administered. The mean follow-up period was 5.3 months. Pelvic cavity flatulency was totally released in 12 patients and 1 partially released. Two of 5 patients with algopareunia recovered and 3 with perineal region varicosis became relieved. On the follow-up ultrasonic examination, all trunks of vena ovarica became occluded. Conclusion This type of foam sclerotherapy is feasible with a high rate of primary occlusion.