Focus of the Report: The focus of the report is on the use of ovarian or internal iliac vein embolization for the treatment of pelvic congestion syndrome (PCS).
Technology Description: Embolization is intended to block the blood supply to the enlarged or swollen veins associated with PCS. Treatment is most commonly directed by venography. The approach for embolization is catheterization through the femoral, subclavian, brachial, or transjugular route using ultrasound guidance. Commonly used embolization agents include platinum embolization coils, foam, glue, and liquid sclerosants, which may be used in conjunction.
Controversy: While there are numerous case series in the literature of patients with PCS treated with embolotherapy, evidence that evaluates treatment of PCS compared with other clinical alternatives is limited. Controversy remains regarding the best approach to diagnosing patients with PCS as well as the most appropriate definition of the syndrome; at present, the causative relationship of anatomical and hemodynamic changes in chronic pelvic pain is based on limited data.
Key Questions:
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Is ovarian or internal iliac vein embolization with or without sclerotherapy effective for the treatment of PCS?
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How does ovarian or internal iliac vein embolization with or without sclerotherapy compare with alternative methods for treatment of PCS?
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Is ovarian or internal iliac vein embolization with or without sclerotherapy safe for the treatment of PCS, and are there long-term safety considerations?
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Have definitive patient selection criteria been established for ovarian or internal iliac vein embolization with or without sclerotherapy for the treatment of PCS?
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