Journal of vascular and interventional radiology : JVIR · 2026
Transvaginal Completion Embolization after Transvenous Treatment of Pelvic Venous Disorders.
СтатьяНазвание и аннотация: Перевод в очереди
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Hakime Antoine, Tselikas Lambros, Moulin Benjamin, Tuil Olivier, Di Primio Massimiliano, Angelopoulos Georgios, Stansal Audrey, Vignaux Olivier, Filmont Jean-Emmanuel, Bendifallah Sofiane
Аннотация
PURPOSE: To evaluate the feasibility, safety, and clinical effectiveness of transvaginal embolization as a completion strategy in women with persistent pelvic pain after technically successful transvenous embolization for pelvic venous disorders (PVDs).
MATERIALS AND METHODS: This retrospective single-center study included 32 consecutive women with persistent symptoms after prior transvenous embolization for PVD. Transvaginal embolization of residual uterovaginal and/or perineal varices was performed under real-time ultrasound (US) and fluoroscopic guidance using an n-butyl cynoacrylate-ethiodized oil emulsion. Primary end point was VAS pain reduction (at rest, during activity, and dyspareunia). Secondary end points included chronic venous insufficiency quality of life questionnaire-14 quality-of-life scores, technical success, 1-month transvaginal Doppler US imaging, and safety. Follow-up was at 1, 3, 6, and 12 months.
RESULTS: Technical success was achieved in all 32 patients (100%). The 1-month transvaginal Doppler US confirmed the absence of residual pelvic varices in all cases. No infectious or access-related adverse events occurred. One asymptomatic proximal pulmonary glue migration into the left pulmonary artery was observed; given its proximal location, catheter-directed thrombaspiration was performed successfully, with no clinical sequelae (Society of Interventional Radiology [SIR] Grade 3). Median visual analog scores decreased significantly across all 3 pain domains from baseline to 12 months (at rest 4 [3-5]→1 [1-2]; during activity 7 [6-8]→1 [1-2]; dyspareunia 8 [7-8]→2 [1-2]; all P < .001). Median chronic venous insufficiency quality of life questionnaire-14 improved from 59.5 (54-63) to 19 (16-21; P < .001).
CONCLUSION: Transvaginal embolization was a feasible completion strategy associated with significant symptom improvement in selected patients after transvenous embolization for PVD, supporting the concept that residual pelvic venous reservoirs may contribute to persistent symptoms.
MATERIALS AND METHODS: This retrospective single-center study included 32 consecutive women with persistent symptoms after prior transvenous embolization for PVD. Transvaginal embolization of residual uterovaginal and/or perineal varices was performed under real-time ultrasound (US) and fluoroscopic guidance using an n-butyl cynoacrylate-ethiodized oil emulsion. Primary end point was VAS pain reduction (at rest, during activity, and dyspareunia). Secondary end points included chronic venous insufficiency quality of life questionnaire-14 quality-of-life scores, technical success, 1-month transvaginal Doppler US imaging, and safety. Follow-up was at 1, 3, 6, and 12 months.
RESULTS: Technical success was achieved in all 32 patients (100%). The 1-month transvaginal Doppler US confirmed the absence of residual pelvic varices in all cases. No infectious or access-related adverse events occurred. One asymptomatic proximal pulmonary glue migration into the left pulmonary artery was observed; given its proximal location, catheter-directed thrombaspiration was performed successfully, with no clinical sequelae (Society of Interventional Radiology [SIR] Grade 3). Median visual analog scores decreased significantly across all 3 pain domains from baseline to 12 months (at rest 4 [3-5]→1 [1-2]; during activity 7 [6-8]→1 [1-2]; dyspareunia 8 [7-8]→2 [1-2]; all P < .001). Median chronic venous insufficiency quality of life questionnaire-14 improved from 59.5 (54-63) to 19 (16-21; P < .001).
CONCLUSION: Transvaginal embolization was a feasible completion strategy associated with significant symptom improvement in selected patients after transvenous embolization for PVD, supporting the concept that residual pelvic venous reservoirs may contribute to persistent symptoms.