The Causes of Ineffective Endovascular Treatment of Pelvic Venous Disorders

Ovarian veins embolization (OVE) and iliac vein stenting are common in the treatment of pelvic venous disorders (PeVD). At the same time, clinical effectiveness (symptom relief) of endovascular treatment for PeVD varies widely. In some cases, endovascular interventions do not have the expected positive effects, and sometimes they are accompanied by clinical deterioration (increased pain). The authors describe several cases of ineffective endovascular interventions caused by wrong choice of treatment of patients with PeVD. These cases demonstrate some obvious causes of ineffective endovascular treatment of PeVD: unjustified pelvic vein embolization, incorrect endovascular stages for iliac and pelvic veins, spiral occlusion of ovarian veins with spiral protrusions. These clinical examples and literature data indicate the need for a multidisciplinary approach to examination and treatment of patients with PeVD, rational and differentiated use of endovascular methods in patients with various forms of PeVD.