Ovarian Vein Embolization Q & A
Ovarian vein embolization is a minimally invasive treatment for pelvic congestion syndrome, a painful condition resulting from the presence of enlarged or varicose veins in the pelvis. It helps relieve pain by using imaging guidance and a catheter to close off faulty veins, so they can no longer enlarge with blood. Embolization is a highly effectively way of controlling bleeding and much less invasive than open surgery.
What is Ovarian Vein Embolization?
Ovarian vein embolization is a minimally invasive treatment for pelvic congestion syndrome that is used to close off faulty veins, so they can no longer enlarge with blood and cause pain.
Pelvic congestion syndrome, also known as ovarian vein reflux, is a painful condition resulting from the presence of varicose veins in the pelvis. The condition is caused by valves in the veins that help return blood to the heart against gravity becoming weakened and not closing properly, allowing blood to flow backwards and pool in the vein causing pressure and bulging veins. Diagnosis of the condition is done through one of several methods: pelvic venography, magnetic resonance imaging and pelvic and transvaginal ultrasound.
During this procedure, the doctor inserts a catheter up the femoral vein and into the faulty vein(s). Catheterization requires only a tiny nick in the skin for insertion and x-ray image guidance of the catheter to its target area. The catheter delivers special coils that clot the blood and seal the faulty vein. For smaller veins, the doctor may also use a special foam agent to block the veins.
How is the procedure performed?
Image-guided, minimally invasive procedures such as embolization for pelvic congestion syndrome should be performed by a specially trained interventional radiologist.
Prior to your procedure, ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) may be performed.
You will be positioned on the examining table.
You may be connected to monitors that track your heart rate, blood pressure and pulse during the procedure.
A nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm so that sedative medication can be given intravenously. Moderate sedation may be used.
The area of your body where the catheter is to be inserted will be sterilized and covered with a surgical drape.
A very small skin incision is made at the site.
Using image-guidance, a catheter (a long, thin, hollow plastic tube) is inserted through the skin to the treatment site.
A contrast material then is injected through your IV and a series of x-rays are taken to locate the exact site of bleeding or abnormality. The medication or embolic agent is then injected through the catheter. Additional angiograms are taken to ensure the embolic agent is correctly positioned and that any bleeding is controlled.
At the end of the procedure, the catheter will be removed, and pressure will be applied to stop any bleeding. The opening in the skin is then covered with a dressing. No sutures are needed.
Your intravenous line will be removed.
You can expect to stay in bed for six to eight hours after your procedure.
The length of the procedure varies from 30 minutes to several hours depending on the complexity of the condition.
What will I experience during and after the procedure?
Devices to monitor your heart rate and blood pressure will be attached to your body.
You will feel a slight pin prick when the needle is inserted into your vein for the intravenous line (IV) and when the local anesthetic is injected. Most of the sensation is at the skin incision site, which is numbed using local anesthetic. You may feel pressure when the catheter is inserted into the vein or artery.
If the procedure is done with sedation, the intravenous (IV) sedative will make you feel relaxed, sleepy and comfortable for the procedure. You may or may not remain awake, depending on how deeply you are sedated.
You may feel slight pressure when the catheter is inserted, but no serious discomfort.
As the contrast material passes through your body, you may experience a warm feeling which quickly subsides.
Most patients experience some side effects after embolization. Pain is the most common and can be controlled by medication given by mouth or through your IV.
Most patients leave the center within 24 hours of the procedure, but those who have considerable pain may have to stay longer.
You should be able to resume your normal activities within a week.