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

Guirola, Jose A. ; Sanchez-Ballestin, Maria ; Sierre, Sergio ; Lahuerta, Celia ; Mayoral, Victoria ; De Gregorio, Miguel A. (Universidad de Zaragoza)

Resumen: 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.

Idioma: Inglés

DOI: 10.1016/j.jvir.2017.09.011

Año: 2018

Publicado en: Journal of vascular and interventional radiology 29, 1 (2018), 45-53
ISSN: 1051-0443

Factor impacto JCR: 2.828 (2018)

Categ. JCR: RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING rank: 44 / 129 = 0.341 (2018) - Q2 - T2
Categ. JCR: PERIPHERAL VASCULAR DISEASE rank: 27 / 65 = 0.415 (2018) - Q2 - T2

Factor impacto SCIMAGO: 0.912 - Cardiology and Cardiovascular Medicine (Q1) - Radiology, Nuclear Medicine and Imaging (Q1) - Medicine (miscellaneous) (Q1)

Tipo y forma: Artículo (PostPrint)

Área (Departamento): Área Radiol. y Medicina Física (Dpto. Pediatría Radiol.Med.Fís)