Embolization Strategies for Pelvic Venous Disorders: Foam + Glue vs Foam + Coils

Exclusion Criteria

• •Pregnancy or planning to conceive within the next 12 months
• •Significant Nutcracker syndrome diagnosed by duplex / CTV / MRV
• •Significant May-Thurner syndrome diagnosed by duplex / CTV / MRV
• •Non-ovarian sources of reflux requiring intervention, including internal iliac vein insufficiency; During venography all patients will undergo selective pelvic venography prior embolization to exclude patients who have combined gonadal and internal iliac vein reflux)
• •History of previous pelvic vein embolization or surgical ligation
• •Coagulopathy, defined as:
• •* INR \> 1.5
• •* Platelet count \< 50 × 10⁹/L
• •Severe comorbidities, including:
• •* Active pelvic infection (e.g., pelvic inflammatory disease)
• •* End-stage renal disease (eGFR \< 30 mL/min/1.73 m²)
• •* Decompensated heart failure (NYHA class III-IV)
• •* Active malignancy requiring treatment
• •Known allergy or hypersensitivity to:
• •Iodinated contrast media
• •Polidocanol (Aethoxysklerol®)
• •N-butyl cyanoacrylate (e.g., Gluebran® 2)
• •Nickel, platinum, or stainless steel (components of embolization coils) . Presence of non-venous pelvic pathology requiring immediate management