Ovarian Vein Embolization

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This procedure is used as a treatment for a painful condition of the lower abdomen called pelvic congestion syndrome or ovarian vein reflux. Somewhat like what happens with varicose veins, veins in the lower abdomen can become enlarged and cause painful pressure. Using a catheter — a thin tube that is inserted though a small nick in the inner thigh — a radiologist administers agents that block the flow of blood to faulty veins. About 85% of women report pain relief or improvement within 2 to 3 weeks.

Need to Know

Nice to Know
  • Don’t take aspirin or Vitamin E at least 5 days before
  • Do not eat or drink anything at least eight hours before the procedure
  • If you have diabetes, ask your primary care doctor about adjusting your insulin dose
  • Tell your technologist about any allergies, especially to local or general anesthetics and contrast materials (“x-ray dye”)
  • Inform your technologist if you are pregnant
  • Before your procedure, you’ll meet with your Jefferson Radiology physician for a consultation
  • Wear comfortable, loose-fitting clothing
  • You’ll be given a gown to wear during your treatment
  • You’ll be awake during the procedure and most-likely can go home after
  • This treatment is a minimally invasive alternative to conventional surgery
  • No surgical incision is needed, just a small nick in the skin
  • You may feel some discomfort after the procedure, but no serious pain

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How Does It Work?

Using a thin tube called a catheter, an interventional radiologist injects a substance called an embolic agent at the site of enlarged pelvic blood vessels. The embolic agent either blocks or causes the body to block the vessel, preventing the accumulation of blood in faulty vessels, and thereby reducing the pelvic congestion.

What Happens — Before, During, and After?

When you arrive for your procedure, a nurse will greet you and let the team know you’ve arrived. Before the procedure, you may have an ultrasound, CT, or MRI exam.

A nurse will bring you into the pre-procedure area and ask you to change into a gown. When you are brought in for your procedure you will be positioned on the examining table. Your doctor will greet you, explain the procedure, and answer any questions you may have. A technologist or nurse will wheel your bed into the procedures room, and you’ll be positioned on the examining table. The technologist or nurse will connect monitors for your heart rate, blood pressure, and pulse, and an intravenous (IV) line will be inserted into a vein in your hand or arm. This will be used to give you sedatives during the procedure. Some patients receive general anesthesia, but in most cases, this is not necessary.

The technologist will shave, sterilize, and cover the area of your body where a catheter will be inserted with a surgical drape, usually the inner thigh. The radiologist will make a very small nick, and you may feel some pressure as the catheter is inserted, but you won’t feel any serious discomfort. Depending on the complexity of your condition, the procedure may take from 30 minutes to several hours. When the catheter is removed, pressure is applied to prevent bleeding, and the nick is bandaged. No sutures are needed.

Most patients feel some discomfort after the procedure. Medications can be given to control pain. You may also experience mild nausea or a low-grade fever. Some patients experience cramps. You will most likely spend the night at Hartford Hospital, although some patients can go home after 6 to 8 hours of observation.

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How Should I Prepare?

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. For example, you may want to arrange to have someone to drop you off and pick you up. You might like to keep a list of questions or — as you’re doing now — educate yourself about the procedure.

Another important part of your preparation will be guided by your doctor:

  • You will need to get blood tests to check your liver and kidney function.
  • Your doctor may also request an EKG.
  • Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin or warfarin) for a time before the procedure.

Some of your preparation will need to be timed to the procedure:

  • Five days before the procedure, stop taking vitamin E.
  • The day before the procedure (or the Friday before, if you're scheduled for a Monday procedure), a nurse from the Interventional Radiology Department will call you. The nurse will give you any additional instructions, and will ask if you have any questions.
  • In the 8 hours before the procedure, do not eat food.
  • Up to 2 hours before you arrive at the hospital, you may drink clear liquids. Black coffee or tea are fine, but do not add cream or milk. You may sip water with medications.
  • When you arrive, make sure the nurse and radiologist know about any allergies you may have, especially allergies to local anesthetics (such as lidocaine), general anesthetics (such as propofol), or X-ray dye (contrast media). If there's any chance you may be pregnant, tell your radiologist.
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What Should I Bring?

You may want to invite a family member or friend to accompany you to your procedure. Some of the things that you might consider taking include:

  • Wear comfortable, loose-fitting clothes
  • Wear comfortable shoes
  • Avoid bringing jewelry or valuables
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What Are the Benefits and Risks?

The benefits of ovarian vein embolization could include:

  • High chances of success. Success rates of 85% and higher have been reported with this procedure worldwide.
  • The procedure is much less invasive than conventional surgical techniques. Your hospital stay is much shorter, and the recovery is faster. You lose less blood, and there’s no scar.

Risks you should be aware of include:

  • The small chance that the procedure will not be successful in relieving your pain
  • Like any catheterization procedure, there is a risk of damage to blood vessels, bruising, bleeding, or infection at the puncture site
  • There is a small risk of infection at the site of embolization, even with antibiotics
  • The embolic agent could go someplace it is not supposed to go, and harm normal tissue

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.

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