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Complications and Adverse Events of Gonadal Vein Embolization with Coils

Sergey G Gavrilov1, Nadezhda Y Mishakina1, Oksana I Efremova1

  • 1Department of Fundamental and Applied Research in Surgery, Pirogov Russian National Research Medical University, 10/5 Leninsky Prospect, Moscow 119049, Russia.

Journal of Personalized Medicine
|November 24, 2022
PubMed

Insights

Gonadal vein embolization (GVE) for pelvic venous disease (PeVD) effectively reduces chronic pelvic pain (CPP) in most patients. However, GVE is associated with specific complications, including pelvic vein thrombosis, necessitating careful patient selection and monitoring.

Area of Science:

  • Interventional Radiology
  • Vascular Medicine
  • Gynecology

Background:

  • The efficacy and safety of gonadal vein embolization (GVE) using coils for treating pelvic venous disease (PeVD) remain incompletely understood.
  • Patient and physician expectations are not always met by GVE outcomes, highlighting a need to investigate associated complications.

Purpose of the Study:

  • To assess the incidence and causes of complications following GVE with coils in patients diagnosed with PeVD.
  • To evaluate the effectiveness of GVE in alleviating chronic pelvic pain (CPP) and identify associated adverse events.

Main Methods:

  • A retrospective cohort study involving 150 female patients with PeVD who underwent GVE with coils between 2000 and 2020.
  • Complication rates were assessed 30 days post-GVE using the Society for Interventional Radiology (SIR) classification.
  • Pain severity was measured using the visual analogue scale (VAS), with duplex ultrasound and CT venography used for follow-up.

Main Results:

  • Chronic pelvic pain (CPP) decreased in 72.6% of patients post-GVE (mean VAS from 8.2 to 1.7).
  • Post-embolic syndrome (PES) occurred in 22% of patients, resolving within one month, with an overall GVE efficacy of 94.6% after PES resolution.
  • Complications were observed in 34.6% of patients, including minor events (hematoma, allergic reactions) and major events (coil protrusion, parametrial/uterine vein thrombosis [21.3%], deep calf vein thrombosis [2.7%]).

Conclusions:

  • Gonadal vein embolization (GVE) with coils for PeVD is linked to specific complications, with pelvic vein thrombosis being the most frequent.
  • Post-embolization syndrome (PES) should be recognized as a potential adverse event of GVE procedures.
  • Despite complications, GVE demonstrates significant efficacy in pain relief for a majority of patients with PeVD.

Keywords:
complicationsgonadal vein embolization with coilspelvic venous disorder

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