Joh Maria, Grewal Simer, Gupta Ramona
Interventional Radiology Resident, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Associate Professor of Radiology, Section of Interventional Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Tech Vasc Interv Radiol. 2021 Mar;24(1):100732. doi: 10.1016/j.tvir.2021.100732. Epub 2021 Apr 16.
Pelvic Venous Disease (PeVD) is characterized by pelvic varicosities and chronic pelvic pain, defined as noncyclic pelvic pain that persists for more than 6 months. Pain and discomfort related to PeVD typically worsen with upright positioning and occur more frequently in multiparous and premenopausal women. The most common cause of PeVD is pelvic venous insufficiency (PVI) due to incompetent valves. Noninvasive imaging modalities such as ultrasound, computed tomography, or magnetic resonance imaging, and invasive catheter-based venography can help characterize varicosities and venous insufficiency, supporting the diagnosis of PeVD. In patients with PeVD, ovarian and/or internal iliac vein embolization demonstrate excellent technical and clinical success rates with relatively low complication rates and should be considered as standard management, in conjunction with medical therapy. Appropriate diagnostic work-up and patient selection are important prior to any intervention for achieving therapeutic success, as multiparous women have a higher success rate compared to patients with dyspareunia after embolization therapy. Post-procedure follow-up is critical for assessing symptom improvement and need for repeat intervention. However, further research is needed to identify additional predictors of successful outcomes after embolization therapy. This article aims to provide an overview of patient selection, interventional technique, challenges, and outcomes of ovarian vein embolization.
盆腔静脉疾病（PeVD）的特征是盆腔静脉曲张和慢性盆腔疼痛，慢性盆腔疼痛定义为持续超过6个月的非周期性盆腔疼痛。与PeVD相关的疼痛和不适通常在直立位时加重，在经产妇和绝经前女性中更常见。PeVD最常见的原因是瓣膜功能不全导致的盆腔静脉功能不全（PVI）。超声、计算机断层扫描或磁共振成像等非侵入性成像方式以及基于导管的侵入性静脉造影有助于明确静脉曲张和静脉功能不全的特征，支持PeVD的诊断。在PeVD患者中，卵巢和/或髂内静脉栓塞术显示出良好的技术成功率和临床成功率，并发症发生率相对较低，应与药物治疗一起作为标准治疗方法。在进行任何干预以取得治疗成功之前，进行适当的诊断检查和患者选择很重要，因为经产妇与栓塞治疗后性交困难的患者相比成功率更高。术后随访对于评估症状改善情况和重复干预的必要性至关重要。然而，需要进一步研究以确定栓塞治疗后成功结果的其他预测因素。本文旨在概述卵巢静脉栓塞术的患者选择、介入技术、挑战和结果。
