A Randomized Trial of Endovascular Embolization Treatment in Pelvic Congestion Syndrome: Fibered Platinum Coils versus Vascular Plugs with 1-Year Clinical Outcomes

作者：Guirola Jose A; Sanchez Ballestin Maria; Sierre Sergio; Lahuerta Celia; Mayoral Victoria; De Gregorio Miguel A^*

来源：Journal of Vascular and Interventional Radiology, 2018, 29(1): 45-53.

DOI：10.1016/j.jvir.2017.09.011

Purpose: To compare safety and efficacy of vascular plugs (VPs) and fibered platinum coils (FPCs) for embolization in pelvic congestion syndrome (PCS).
Materials and Methods: A randomized, prospective, single-center study enrolled 100 women with PCS from January 2014 to January 2015. Patients were randomly assigned to 2 groups, and embolization was performed with FPCs (n = 50) or VPs (n = 50). Mean age of patients was 42.7 years +/- 7.60, and mean visual analog scale (VAS) score for pelvic pain before treatment was 7.4 +/- 7.60. Primary outcome (clinical success at 1 y using a VAS), number of devices, procedure and fluoroscopy times, radiation doses, costs, and complications were compared, and participants were followed at 1, 3, 6, and 12 months.
Results: Clinical success and subjective improvement were not significantly different at 1-year follow-up (89.7% for FPCs vs 90.6% for VPs; P =.760). Mean number of devices per case was 18.2 +/- 1.33 for FPCs and 4.1 +/- 0.31 for VPs (P <.001). Three FPCs and 1 VP migrated to pulmonary vasculature approximately 3-6 months after the embolization procedure; all were retrieved without complications. The FPC group had a significantly longer fluoroscopy time (33.4 min +/- 4.68 vs 19.5 min 6.14) and larger radiation dose (air kerma 948.0 mGy +/- 248.45 vs 320.7 mGy +/- 134.33) (all P <.001).
Conclusions: Embolization for PCS resulted in pain relief in 90% of patients; clinical success was not affected by embolic device. VPs were associated with decreased fluoroscopy time and radiation dose.

• 出版日期2018-1