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MRI associated factors of clinical efficacy of embolization in patients with pelvic venous insufficiency

2020; Elsevier BV; Volume: 101; Issue: 10 Linguagem: Inglês

10.1016/j.diii.2020.06.004

2211-5684

Eva Jambon, Y. Le Bras, F. Petitpierre, E. Balian, Dominique Midy, N. Grenier, Clément Marcelin,

Vascular anomalies and interventions

The purpose of this study was to identify anatomical findings at magnetic resonance imaging (MRI) associated with successful percutaneous embolization in women with pelvic venous insufficiency (PVI). Between 2008 and 2018, 168 consecutive women (mean age, 39 ± 9 [SD] years; range: 21–69 years) who underwent percutaneous embolization for PVI confirmed by MRI and phlebography were included. Clinical efficacy of embolization was evaluated by patients' opinion or visual analogue scale. Associated factors of success of embolization were searched by comparing MRI findings in women with successful embolization with those in women with failed embolization using univariate analyses. The mean follow-up was 36 ± 29 (SD) months (range: 12–138 months). Clinical efficacy of embolization was obtained in 126/168 women (75%), complete symptom improvement in 33/168 women (20%) and significant partial improvement in 92/168 women (55%). No symptom improvement and symptoms exacerbation were observed in 17/168 (10%) and 2/168 (1%) women, respectively. At univariate analysis, right ovarian vein diameter ≤ 7 mm and vulvar varicosities were associated with successful embolization (P = 0.04 and P = 0.01, respectively) and left ovarian vein diameter ≤ 7 mm was associated with a complete improvement of symptoms (P = 0.03). At multivariate analysis, a small right ovarian vein diameter was the single MRI variable associated with clinical efficacy of embolization (P = 0.04). Small ovarian vein diameters on MRI are associated with best clinical efficacy of percutaneous embolization in PVI. Right ovarian vein diameter > 7 mm should warrant further phlebography to exclude venous insufficiency.