Hipola Jose María, Alonso Alberto, Cárdenas Regina, Pillado Eugenia, Leal Jose Ignacio
Department of Vascular Surgery, Clínica Universidad de Navarra, Madrid, Spain.
Department of Interventional Radiology, Clínica Universidad de Navarra, Madrid, Spain.
J Vasc Surg Venous Lymphat Disord. 2025 May 14;13(5):102256. doi: 10.1016/j.jvsv.2025.102256.
The aim of this study was to evaluate the safety and efficacy of ovarian vein embolization using N-butyl-2 cyanoacrylate (NBCA) for treating pelvic venous disorder-associated chronic pelvic pain.
This retrospective study analyzed 100 patients who underwent ovarian vein embolization with NBCA at a single institution between February 2018 and June 2024. Pelvic venous insufficiency was confirmed by duplex ultrasound and abdominal computed tomography or magnetic resonance imaging, and NBCA was the sole embolic agent. Pain levels were assessed pre- and post-procedure using the Visual Analogue Scale (VAS) in three categories: pain on standing, dyspareunia, and menstrual pain. Follow-up included clinical evaluation and VAS scoring at 1 to 3 months and annually. Statistical analysis determined the significance of pain reduction.
Technical success was achieved in all cases, with complete occlusion of the target veins. Clinical success was observed in most patients, with significant improvement in VAS scores across all categories (P < .05). Due to symptom recurrence, four patients (4%) required reintervention during follow-up. No NBCA-related complications were reported.
In our study, ovarian vein embolization with NBCA appears to be a safe and effective treatment for pelvic venous disorder-associated chronic pelvic pain, providing significant pain relief. Additionally, it offers advantages over permanent metal implants such as the potential for gradual polymer degradation over time and avoiding interference in future imaging studies.
本研究旨在评估使用氰基丙烯酸正丁酯(NBCA)进行卵巢静脉栓塞治疗盆腔静脉疾病相关慢性盆腔疼痛的安全性和有效性。
这项回顾性研究分析了2018年2月至2024年6月期间在单一机构接受NBCA卵巢静脉栓塞的100例患者。通过双功超声以及腹部计算机断层扫描或磁共振成像确认盆腔静脉功能不全,且NBCA是唯一的栓塞剂。使用视觉模拟量表(VAS)在术前和术后评估三种类型的疼痛水平:站立时疼痛、性交困难和痛经。随访包括在1至3个月以及每年进行临床评估和VAS评分。统计分析确定疼痛减轻的显著性。
所有病例均取得技术成功,目标静脉完全闭塞。大多数患者观察到临床成功,所有类型的VAS评分均有显著改善(P <.05)。由于症状复发,4例患者(4%)在随访期间需要再次干预。未报告与NBCA相关的并发症。
在我们的研究中,使用NBCA进行卵巢静脉栓塞似乎是治疗盆腔静脉疾病相关慢性盆腔疼痛的一种安全有效的方法,可显著缓解疼痛。此外,与永久性金属植入物相比,它具有随着时间推移聚合物逐渐降解的潜力以及避免干扰未来影像学检查等优势。