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Title: Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes

Abstract

Until recently, the main indication for pelvic vein embolization (PVE) in women was to treat pelvic venous congestion syndrome (PVC) but increasingly, patients with refluxing pelvic veins associated with leg varicosities are also being treated. A more unusual reason for PVE is to treat pelvic venous malformations, although such lesions may be treated with sclerotherapy alone. Embolotherapy for treating PVC has been performed for many years with several published studies included in this review, whilst an emerging indication for PVE is to treat lower limb varicosities associated with pelvic vein reflux. Neither group, however, has been subjected to an adequate randomized, controlled trial. Consequently, some of the information presented in this review should be considered anecdotal (level III evidence) at this stage, and a satisfactory ‘proof’ of clinical efficacy remains deficient until higher-level evidence is presented. Furthermore, a wide range of techniques not accepted by all are used, and some standardization will be required based on future mandatory prospective studies. Large studies have also clearly shown an unacceptably high recurrence rate of leg varicose veins following venous surgery. Furthermore, minimally or non-invasive imaging is now revealing that there is a refluxing pelvic venous source in a significant percentage of womenmore » with de novo leg varicose veins, and many more with recurrent varicosities. Considering that just over half the world’s population is female and a significant number of women not only have pelvic venous reflux, but also have associated leg varicosities, minimally invasive treatment of pelvic venous incompetence will become a common procedure.« less

Authors:
 [1]
  1. The Imaging Clinic (United Kingdom)
Publication Date:
OSTI Identifier:
22469866
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 38; Journal Issue: 4; Other Information: Copyright (c) 2015 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2015 The Author(s); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; LEGS; MALFORMATIONS; PATIENTS; PVC; REVIEWS; STANDARDIZATION; SURGERY; VASCULAR DISEASES; VEINS; WOMEN

Citation Formats

Lopez, Anthony James, E-mail: consultant@radiologist.co.uk. Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes. United States: N. p., 2015. Web. doi:10.1007/S00270-015-1074-7.
Lopez, Anthony James, E-mail: consultant@radiologist.co.uk. Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes. United States. https://doi.org/10.1007/S00270-015-1074-7
Lopez, Anthony James, E-mail: consultant@radiologist.co.uk. 2015. "Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes". United States. https://doi.org/10.1007/S00270-015-1074-7.
@article{osti_22469866,
title = {Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes},
author = {Lopez, Anthony James, E-mail: consultant@radiologist.co.uk},
abstractNote = {Until recently, the main indication for pelvic vein embolization (PVE) in women was to treat pelvic venous congestion syndrome (PVC) but increasingly, patients with refluxing pelvic veins associated with leg varicosities are also being treated. A more unusual reason for PVE is to treat pelvic venous malformations, although such lesions may be treated with sclerotherapy alone. Embolotherapy for treating PVC has been performed for many years with several published studies included in this review, whilst an emerging indication for PVE is to treat lower limb varicosities associated with pelvic vein reflux. Neither group, however, has been subjected to an adequate randomized, controlled trial. Consequently, some of the information presented in this review should be considered anecdotal (level III evidence) at this stage, and a satisfactory ‘proof’ of clinical efficacy remains deficient until higher-level evidence is presented. Furthermore, a wide range of techniques not accepted by all are used, and some standardization will be required based on future mandatory prospective studies. Large studies have also clearly shown an unacceptably high recurrence rate of leg varicose veins following venous surgery. Furthermore, minimally or non-invasive imaging is now revealing that there is a refluxing pelvic venous source in a significant percentage of women with de novo leg varicose veins, and many more with recurrent varicosities. Considering that just over half the world’s population is female and a significant number of women not only have pelvic venous reflux, but also have associated leg varicosities, minimally invasive treatment of pelvic venous incompetence will become a common procedure.},
doi = {10.1007/S00270-015-1074-7},
url = {https://www.osti.gov/biblio/22469866}, journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 4,
volume = 38,
place = {United States},
year = {Sat Aug 15 00:00:00 EDT 2015},
month = {Sat Aug 15 00:00:00 EDT 2015}
}