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.
