Pelvic Vein Embolisation of Gonadal and Internal Iliac Veins Can be Performed Safely and with Good Technical Results in an Ambulatory Vein Clinic, Under Local Anaesthetic Alone: Results from Two Years’ Experience

Background: Pelvic vein embolisation is increasing in venous practice for the treatment of conditions associated with pelvic venous reflux. In July 2014, we introduced a local anaesthetic “walk-in walk-out” pelvic vein embolisation service situated in a vein clinic, remote from a hospital. Method(s): Prospective audit of all patients undergoing pelvic vein embolisation for pelvic venous reflux. All patients had serum urea and electrolytes tested before procedure. A combination of coil embolisation and sclerosant were used in all patients. We noted (1) complications during or post-procedure (2) successful abolition of pelvic venous reflux on transvaginal duplex scanning (3) number of veins (territories) treated and number of coils used. Result(s): In 24 months, 121 patients underwent pelvic vein embolisation. Three males were excluded as transvaginal duplex scanning was impossible and six females excluded due to lack of complete data. None of these nine had any complications. Of 112 females analysed, mean age 45 years (24-71), 104 were for leg varicies, 48 vulval varicies and 20 for pelvic congestion syndrome (some had more than one indication). There were no deaths/serious complications at 30 days. Two procedures were abandoned, one completed subsequently and one was technically successful on review. One more had transient bradycardia and one had a coil removed by snare during the procedure. The mean number of venous territories treated was 2.9 and a mean of 3.3 coils was used per territory. Conclusion(s): Pelvic vein embolisation under local anaesthetic is safe and technically effective in a remote out-patient facility outside of a hospital.

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Artikel online veröffentlicht:
11. Mai 2021