Ovarian vein embolization

Ovarian vein embolization is an interventional technique primarily used towards the treatment of varicosities.

Indications

The main indications are:

  • as part of management of pelvic congestion syndrome
    • to treat pelvic varicosities diagnosed by imaging
    • to treat labial and/or perineal varicosities
Contraindications
  • allergic reaction to contrast media
  • coagulopathy
  • renal insufficiency
Preprocedural assessment
  • clinical history and examination of pelvis and perineum by a gynecologist
  • pelvic ultrasound/CT/MRI
  • diagnostic laparoscopy in selected cases
  • patient counseling: etiology of the chronic pelvic pain and its treatment options
Patient preparation
  • informed consent
  • IV access
  • clear fluids per oral for 4-6 hours prior to procedure
  • sedation with Midazolam 2 mg and fentanyl 100 microgram IV
Procedure
  • venous access can be either through a internal jugular route or a femoral venous route
  • after introducing a 5-7 F vascular sheath in the selected vein, an appropriate 5 F catheter is advanced into the left renal vein (multipurpose catheter through IJV access; Cobra catheter through femoral vein access)
  • renal venography is performed by a forceful injection while patient is performing Valsalva maneuver
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