Anatomical Abnormalities of the Pelvic Venous System and their Implications for Endovascular Management of Pelvic Venous Reflux

Background: Pelvic venous reflux is often treated with pelvic vein embolisation; however, atypical pelvic venous anatomy may provide therapeutic challenges. Method(s): We retrospectively over 100 patient files and reported symptoms and diagnostic imaging. Patients in which aberrant anatomy had been demonstrated was reviewed. We discuss the basic techniques of Pelvic Vein Embolisation and highlight in a pictorial review the range of anatomical abnormalities demonstrated in the female pelvis. Result(s): Anatomical abnormalities demonstrated included internal iliac veins draining into the contralateral common iliac vein, duplicated inferior vena cava, reverse-angle renal veins with atypical left ovarian vein drainage and direct drainage of the internal iliac vein to the inferior vena cava. All patients were successfully treated with pelvic vein embolisation. Catheter choice and approach to treatment when facing anatomical variations are shown. Conclusion(s): Abnormal embryological development may cause variable pelvic venous anatomy. Knowledge of this will enable interventional radiologists to successfully treat such patients. This pictorial review demonstrates the most commonly encountered abnormalities and the challenges to interventional radiology in Pelvic Vein Embolisation.

Publication History

Article published online:
11 May 2021