Highlights
- •The incidence of venous thromboembolism (VTE) after interventions on the ovarian veins in patients with pelvic venous disorder (PeVD) is not well established.
- •We compared VTE rates after ovarian vein resection (OVR) and ovarian vein embolization (OVE) in patients with PeVD.
- •VTE was found to be more frequent after OVE with coils than after OVR (in 27% and 10% of patients, respectively; P = 0.001). The odds ratio for developing VTE after OVE with coils was 10 times higher than after OVR.
Background
Ovarian vein resection (OVR) and ovarian vein embolization (OVE) are effective options
for treating patients with pelvic venous disorder (PeVD). However, due to in an abrupt
cessation of blood flow in the ovarian veins (OVs), these interventions can be complicated
by pelvic vein thrombosis (PVT). The aim of this study was to assess venous thromboembolism
(VTE) rates after OVR and OVE in patients with PeVD.
Methods
This retrospective cohort study included 272 patients with PeVD who underwent OVR
(n = 122) or OVE with coils (n = 150). The rates and clinical manifestations of VTE were assessed in each group
on days 1 and 3 after the intervention using duplex ultrasonography. Vein patency,
blood flow velocity, and localization of thrombi in the pelvic (parametrial, uterine,
and ovarian), iliac, superficial, and deep veins of the lower extremities were examined.
PVT was defined as the formation of blood clots in nontarget (i.e. not intended to
intervention) veins of the pelvis (parametrial, uterine veins, or tributaries of the
internal iliac veins).
Results
VTE after OVR and OVE was identified in 52 (19%) out of 272 patients. In the OVR group,
PVT and calf deep vein thrombosis were detected in 9% and 1% of patients, accordingly,
while in the OVE group their rates were almost three times higher (24% and 3%; both
P = 0.001). In both groups, the most common VTE was PVT. The odds ratio for developing
VTE with coils was 10 times higher (95% confidence interval: 2.35–56.43) after OVE
than after OVR. Clinical manifestations of PVT were observed in 2.5% of patients,
and the rest patients were asymptomatic. No cases of pulmonary embolism occurred.
Conclusions
VTE after interventions of the ovarian vein in patients with PeVD occurs in every
fifth patient. OVE is associated with a higher incidence of PVT.
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Article info
Publication history
Published online: December 01, 2022
Accepted:
November 12,
2022
Received:
February 22,
2022
Footnotes
Author Contributions: The manuscript has been read and approved for submission to AVS by all authors. Study concept and design: Sergey Gavrilov. Acquisition, analysis, or interpretation of data: Sergey Gavrilov, Nadezhda Mishakina, Anastasiya Grishenkova. Drafting of the manuscript: Sergey Gavrilov, Nadezhda Mishakina, Anastasiya Grishenkova. Statistical analysis: Nadezhda Mishakina, Anastasiya Grishenkova. Critical revision of the manuscript for important intellectual content: Sergey Gavrilov, Nadezhda Mishakina,. Anastasiya Grishenkova.
Conflicts of interest: No.
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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