Comparative analysis of the efficacy and safety of endovascular and endoscopic interventions on the gonadal veins in the treatment of pelvic congestion syndrome

Sg, Gavrilov; Сажин, А. В.; Krasavin, G.V.; Москаленко, Е. П.; Mishakina, N.Yu.

doi:10.1016/j.jvsv.2020.05.013

Cited by 16 publications

(12 citation statements)

References 20 publications

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“…16 A more recent study of 28 patients who underwent endoscopic gonadal vein resection similarly reported minimal complications. 17 Embolization of the gonadal vein is a welltolerated treatment of varicocele in males and pelvic congestion syndrome in females, with complications occurring in 3-10% and largely related to the procedure itself such as recurrence of varices or nontarget embolization. 18,19 In the setting of kidney transplantations, gonadal vein resection does not impact the frequency of ureteral complications.…”

Section: Discussionmentioning

confidence: 99%

Gonadal vein as a bypass conduit for arterial reconstruction during an aortic debranching repair of a paravisceral aortic aneurysm

Yan

Choi

Chen

2021

Journal of Vascular Surgery Cases, Innovations and Techniques

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 99%

Gonadal vein as a bypass conduit for arterial reconstruction during an aortic debranching repair of a paravisceral aortic aneurysm

Yan

Choi

Chen

2021

Journal of Vascular Surgery Cases, Innovations and Techniques

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Section: Methodsmentioning

confidence: 99%

“…The study population included cohort of patients who underwent GV embolization and resection and were reported in our previous studies. 11,14 Due to the prospective nature of the study, five patients were subsequently added to this cohort in accordance with the selection criteria (4 after GV embolization, and 1 after GV resection), so the total number of patients increased to 100.…”

Section: Methodsmentioning

confidence: 99%

“…The methodology of these studies is described in detail elsewhere. 11,14 Pelvic veins (gonadal, parametrial, and uterine) were considered dilated if their diameter was greater than 5 mm. 15 Reflux in the pelvic veins was considered pathological if it lasted for more than 1 s. 15,16 All patients underwent clinical examination prior to intervention on GV, which included an assessment of complaints, medical history, evaluation of the severity of pelvic pain, heaviness in hypogastrium and dyspareunia using a visual analogue scale, and calculation of body mass index.…”

Section: Methodsmentioning

confidence: 99%

“…In our previous studies, we have demonstrated the comparable efficacy and safety of embolization and resection of gonadal veins (GV) in the treatment of patients with PeVD and reported incidence rates of postembolization syndrome (PES) after embolization with coils. 11,14 However, previous studies were based on the evaluations of treatment outcomes by doctors. In the present study, we attempted to assess treatment results by patients in the short- and long-term period.…”

Section: Introductionmentioning

confidence: 99%

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Use of a novel Likert scale instrument to assess patient satisfaction following endovascular and surgical treatment of pelvic venous disorders

Grishenkova

Mishakina

et al. 2022

Phlebology

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Objective The study was aimed at assessing satisfaction with endovascular and surgical treatment, using a novel Likert scale procedure satisfaction instrument, in patients with pelvic venous disorder (PeVD) caused by the gonadal vein reflux. Methods This prospective cohort study included 100 women with PeVD who underwent gonadal veins embolization with coils (GVE group, n = 71) or gonadal veins endoscopic resection (GVR group, n = 29) in 2012–2020. The GVE was performed under local anesthesia and sedation, and was left-sided in 61, right-sided in three, and bilateral in seven patients. The GVR was performed under general anesthesia through transperitoneal ( n = 19) or retroperitoneal ( n = 10) access with three access ports in both cases. The GVR was left-sided in 19, right-sided in one, and bilateral in nine patients. To assess satisfaction with GVE and GVR treatment of PeVD, patients were asked to evaluate statements related to their experience using a new Likert scale instrument. The responses for each item were compared between the groups at Day 7 (D7) and at Month 6 (M6) after the procedure, as was a summary score of all the responses at both time points. The summary score allowed categorization on a spectrum from “completely satisfied” to “completely dissatisfied.” Results The comparison between GVЕ and GVR groups at D7 showed that 80% and 100% of patients, accordingly, reported the overall summary satisfaction, 49% and 79% agreed with a complete pelvic pain relief by D7, 79% and 0% agreed with the absence of a significant discomfort during the first postoperative day, 71% and 100% reported no need for analgesics to relief pain in the assess area, 80% and 100% reported fast return to daily activity, and 19.7% and 100% still experienced pelvic pain at D7 (pain in the GVR group was more severe and required the use of analgesics) (all p < .05). At the same time, 94% and 96% patients were satisfied with the aesthetic result of the procedure at D7 ( p = n.s.). The comparison between GVЕ and GVR groups at M6 showed that 100% of patients in both groups reported overall satisfaction with treatment ( p = n.s.), 96% and 100% confirmed a complete pelvic pain relief by M6, 79% and 65% agreed with the absence of a significant discomfort after the procedure, 79% and 65% reported no need for analgesics, 83% and 100% reported about the return to daily activity (all p < .05), and 100% in both groups were satisfied with the aesthetic result of the procedure ( p = n.s.). Conclusions In patients with PeVD, both GVE and GVR are associated with a high, although not significantly different, overall treatment satisfaction in the long term and have advantages and disadvantages. GVE is associated with less severe post-procedural pain, while GVR provides faster relief of pelvic pain and a return to usual daily activity.

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Efficacy of embolotherapy for the treatment of pelvic congestion syndrome: A systematic review

Hanna,

Bruinsma,

Temperley

et al. 2024

Ir J Med Sci

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Pelvic congestion syndrome (PCS) poses a significant health, diagnostic, and economic challenges. Transcatheter embolisation has emerged as a promising treatment for PCS. A systematic review was performed in order to assess the safety and efficacy of transcatheter embolisation in the treatment of PCS. A systematic search of electronic databases was performed using ‘PubMed’, ‘Embase’, ‘Medline (OVID)’, and ‘Web of Science’, for articles pertaining to efficacy of embolotherapy for the treatment of pelvic congestion syndrome. A total of 25 studies were included in this systematic review with a combined total of 2038 patients. All patients included were female with a mean average age of 37.65 (31–51). Of the 25 studies, 18/25 studies reported pre- and post-procedural pelvic pain outcomes using a visual analogue scale (VAS). All studies showed a reduction in VAS post-procedure. Transcatheter embolisation had a high technical success rate (94%) and an overall complication rate of 9.0%, of which 10.4% were major and 89.6% were minor. Fifteen out of 19 (78.9%) major complications required a subsequent intervention. Transcatheter embolisation using various techniques is effective and safe in treating PCS. A low quality of evidence limits the currently available literature; however, embolisation has shown to improve symptoms in the majority of patients with low complication rates and recurrence rates.

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Comparative analysis of the efficacy and safety of endovascular and endoscopic interventions on the gonadal veins in the treatment of pelvic congestion syndrome

Cited by 16 publications

References 20 publications

Gonadal vein as a bypass conduit for arterial reconstruction during an aortic debranching repair of a paravisceral aortic aneurysm

Gonadal vein as a bypass conduit for arterial reconstruction during an aortic debranching repair of a paravisceral aortic aneurysm

Use of a novel Likert scale instrument to assess patient satisfaction following endovascular and surgical treatment of pelvic venous disorders

Efficacy of embolotherapy for the treatment of pelvic congestion syndrome: A systematic review

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