Ovarian vein embolization is an interventional technique primarily used towards the treatment of pelvic varicosities.
Indications
The main indications are:
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as part of the management of pelvic congestion syndrome 1-4
to treat pelvic varicosities diagnosed by imaging
to treat labial and/or perineal varicosities
Contraindications
allergic reaction to contrast media
coagulopathy
renal insufficiency
Preprocedural assessment
clinical history and examination of the pelvis and perineum by a gynecologist
pelvic ultrasound/CT/MRI
diagnostic laparoscopy in selected cases
patient counseling: etiology of the chronic pelvic pain and its treatment options
Patient preparation
informed consent
IV access
clear fluids per oral for 4-6 hours prior to procedure
sedation with Midazolam 2 mg and fentanyl 100 microgram IV
Procedure
venous access can be either through a upper arm vein route (basilic vein) or a femoral venous route
introducing a 5-7 F vascular sheath in the selected vein
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advancing a 5 F catheter into the left renal vein using:
multipurpose or Simmons catheter if going thourgh the basilic vein or IJV
Cobra catheter if the through femoral vein access
renal venography is performed by a forceful injection while patient is performing Valsalva maneuver