A systematic review on isolated coil embolization for pelvic venous reflux
File(s)
Accepted version
Author(s)
Sutanto, Sharon A
Tan, Matthew
Onida, Sarah
Davies, Alun H
Type
Journal Article
Abstract
OBJECTIVE: Pelvic venous reflux (PVR) can present with symptoms such as chronic pelvic pain, dysmenorrhea, and dyspareunia, resulting in a decreased quality of life among those affected. Percutaneous coil embolization (CE) is a common intervention for PVR; however, the efficacy and safety of its use in isolation has yet to be reviewed. METHODS: The MEDLINE and EMBASE databases were systematically searched from 1990 to July 20, 2020, for studies reporting on adult patients undergoing isolated CE for PVR. Articles not in English, case reports, studies reporting on pediatric patients, and studies not performing isolated CE were excluded. Search, review, and data extraction were performed by two independent reviewers (S.S. and M.T.). Changes in pain before and after CE was evaluated through a pooled analysis of visual analogue scale scores in seven studies. RESULTS: A total of 970 patients (range, 3-218, 100% female) undergoing isolated ovarian vein or mixed veins embolization from 20 studies were included. Pooled analysis revealed mean improvements of 5.47 points (95% CI, 4.77-6.16) on the visual analogue scale. Common symptoms such as urinary urgency and dyspareunia reported significant improvements of 78-100% and 60-89.5% respectively. Complications were rare, with coil migration (n = 19) being the most common. Recurrence rates differed based on the varying symptoms and studies, with recurrence in pain 1-2 years after CE ranging from 5.9-25%. Two randomized controlled trials revealed improved clinical outcomes with CE as compared with vascular plugs and hysterectomy. CONCLUSIONS: The current data suggests that isolated CE is technically effective and can result in clinical improvement among patients with PVR. However, further trials are required to ascertain its long-term effects.
Date Issued
2022-01
Date Acceptance
2021-07-11
Citation
Journal of vascular surgery. Venous and lymphatic disorders, 2022, 10 (1), pp.224-232.e9
ISSN
2213-3348
Publisher
Elsevier
Start Page
224
End Page
232.e9
Journal / Book Title
Journal of vascular surgery. Venous and lymphatic disorders
Volume
10
Issue
1
Copyright Statement
© 2021 Published by Elsevier Inc. on behalf of the Society for Vascular Surgery. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34358670
PII: S2213-333X(21)00389-9
Subjects
Coil embolization
Pelvic congestion syndrome
Pelvic pain
Pelvic venous reflux
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2021-08-04