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Gavrilov S.G.
Pirogov Russian National Research Medical University
Kirsanov K.V.
Pirogov Russian National Research Medical University
Efremova O.I.
Pirogov Russian National Research Medical University
Complications of Gonadal Vein Embolization with Coils: Causes and Consequences
Journal: Journal of Venous Disorders. 2022;16(3): 185‑194
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To cite this article:
Gavrilov SG, Mishakina NYu, Kirsanov KV, Efremova OI. Complications of Gonadal Vein Embolization with Coils: Causes and Consequences. Journal of Venous Disorders.
2022;16(3):185‑194. (In Russ.)
https://doi.org/10.17116/flebo202216031185
Efficacy and safety of gonadal vein embolization (GVE) with coils for pelvic congestion syndrome (PCS) has not been definitively determined. The outcomes of this technique do not meet the requirements of physicians and patients.
To study the incidence and causes of complications after GVE with coils in patients with PCS.
A retrospective cohort study included 150 female patients with PCS who underwent GVE with coils between 2000 and 2021. GVE was performed according to standard technique. Gianturco coils were used in 23% of patients, MReye coils — in 77% of patients. Severity of pain before and after procedure was assessed using a visual analogue scale (VAS). All patients underwent Doppler ultrasound after GVE. Patients with persistent pain syndrome and suspected gonadal vein perforation required CT venography. Complications after GVE were recorded within 30 days after procedure. We assessed unfavorable events according to the Society for Interventional Radiology (SIR) grading system.
Within 30 days after GVE, pelvic pain decreased in 109 (72.6%) patients (from preoperative 8.2±1.5 to 1.7±0.8 scores after surgery; p=0.002) and persisted in 41 (27.4%) patients (8.1±0.7 scores at baseline and 7.8±0.4 scores after embolization; p=0.71). Complications occurred in 85 (56.6%) patients. Minor complications included access-site hematoma (4%) and allergic reactions (1.3%). Major adverse events included protrusion of coils (5.3%), post-embolization syndrome (22%), thrombosis of parametrial, uterine and deep veins of the calf (24%).
GVE with coils in the treatment of PCS is often associated with complications. Improvement of GVE technique, new embolization agents, choice of treatment approach depending on constitutional characteristics of patients and postoperative anticoagulation will be valuable to minimize postoperative morbidity.
Keywords:
Authors:
Gavrilov S.G.
Pirogov Russian National Research Medical University
Kirsanov K.V.
Pirogov Russian National Research Medical University
Efremova O.I.
Pirogov Russian National Research Medical University
Received:
20.04.2022
Accepted:
12.05.2022
List of references:
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