[Mechanochemical endovenous obliteration of the gonadal vein (case report)]

Presented herein is a clinical case report regarding mechanochemical obliteration of the gonadal vein in a 42-year-old female patient suffering from manifestations of pelvic venous plethora for 6 previous years. The examination revealed a primary form of pelvic varicose disease with dilatation of the left ovarian and uterine veins, bilateral veins of the pampiniform plexus. In conditions of the X-ray operating room, inserted into the lumen of the left ovarian vein was the Flebogrif device for mechanical ablation. Appropriate application of the device with simultaneous administration of a sclerosing agent resulted in mechanical and chemical damage of the venous wall. The outcome thus obtained was cessation of intraluminal blood flow. The woman was examined at 3, 6, 12 and 24 months postoperatively. Reduction of venous reflux was accompanied by normalization of pelvic phlebohemodynamics and regression of clinical symptomatology, confirmed by clinical and instrumental methods of examination. This case report demonstrates feasibility, efficacy and safety of the procedure performed. The developed mechanochemical method makes it possible to improve outcomes of surgical treatment of women with pelvic varicose veins, since it is devoid of a series of disadvantages intrinsic to the traditional type of endovascular treatment involving implantation of foreign material in the form of embolizing microcoils. To confirm this hypothesis, it is necessary to carry out randomized comparative trials with participation of a sufficient number of patients.