Endovasular treatment of Pelvic Congestion Syndrome (PCS) in 246 women, long term results, and analysis of patient satisfaction

Monday, March 6, 2023

4:12 PM – 4:21 PM

Location: Phoenix Convention Center, 226ABC

Presenting Author(s)

Ahmed bentridi, MD (he/him/his)

Interventional Radiologist
Hôpital Sacré Coeur

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

SH

Saskia Hazout, PHD

Medical student
UDEM
FT

Farouk Tradi, MD

PUPH
Timone Hospital
Ah

Amina hadjadj, Medical Student

Master Student
CRCHUM
PG

Patrick Gilbert, MD

Interventional Radiologist
CHUM
ET

Eric Therasse, MD

Interventional Radiologist
CHUM
MG

Marie-France Giroux, MD

Interventional Radiologist
CHUM
Gilles Soulez, MD MSc FSIR (he/him/his)

Professor
CHUM

Disclosure(s):

Ahmed bentridi, MD: No financial relationships to disclose

Gilles Soulez, MD MSc FSIR: bard medical: Contracted Research (Ongoing); Cook Medical: Consultant (Ongoing), Intellectual Property Rights (Ongoing), Research Grant Recipient (Ongoing); R3 Vascular: Contracted Research (Ongoing); Siemens Medical: Research Grant Recipient (Ongoing); Starpax: Consultant (Ongoing), Research Grant Recipient (Ongoing); Vitaa Medical: Advisory Committee or Review Panel Member (Ongoing), Consultant (Ongoing), Contracted Research (Ongoing), Research Grant Recipient (Ongoing)

Purpose: Evaluate the long-term efficacy and patient satisfaction following embolization of pelvic congestion syndrome combining sclerosant and mechanical occlusive material

Materials and Methods: A retrospective study included 246 patients embolized for SCP between 2003 and 2021 combined with cross-sectional questionnaires. All adult females who had pelvic congestion syndrome embolization in our center were included, patients lost at follow-up were excluded. Demographic data, patient's symptoms, procedural details, assessment of patient symptom evolution compared to baseline in percentage, and occurrence of complications were documented. On imaging, the extension of the varicose disease was documented on available examinations including US, CT and MRI at baseline and Follow-up. For cross-sectional analysis, patients completed the self-assessment of patient satisfaction; Brief Pain Inventory, drug use and SF 12 questionnaires

Results: From 246 women(M=42Y), 192 were included, 20% had previous treatment for leg varices; The main symptoms were pelvic pain in 79%, lower limb pain in 55%, post-coital dyspareunia in 49%. 505 procedures were performed (mean per patient = 2,09) Usually, the ovarian veins were embolized in the first session at 88%, the branches of the internal iliac vein and or direct puncture of vulvar veins in the following sessions. Foam of Sodium Sulfate (STS) 94%, coils 66% and plugs 53% were used in combination with the technical success of 96%. The mean follow-up was 24±1 months. Recanalization of ovarian veins occurred in only 5%. Less than 3% of minor complications (SIR grade A, B) were reported. For the primary efficacy outcome, 80% of patients get significant improvement at the last follow-up ( >50% compared to the baseline). The mean improvement was estimated at 65% after the first embolization and 71% after two or more embolization.
Regarding the cross-sectional evaluation; 37 patients completed the questionnaire in March 2022, 82% of patients are satisfied after a single embolization and 85% with multiples sessions. A significant decrease in drug use was observed. An update and final of results of the cross-sectional study will be presented at the meeting.

Conclusion: The endovascular treatment of PSC is effective and safe with 80% of long-term improvement. Best results are obtained in sequential treatment with more than one session of embolization