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Embolization in pelvic venous disorders using ethylene vinyl alcohol copolymer (Onyx®) and Aetoxysclerol: a prospective evaluation of safety and long-term efficacy

  • Interventional
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Abstract

Objectives

To prospectively evaluate the safety and efficacy of embolization using ethylene vinyl alcohol copolymer (Onyx®) and Aetoxysclerol for treatment of pelvic venous disorders (PeVD).

Methods

This prospective study was approved by the institutional ethics review board. Ten clinical parameters were retained for evaluation of PeVD (pelvic pain, dyspareunia, post-coital pain, menstruation pain, lower limbs pain, difficulty walking, aesthetic discomfort, impact on daily working life, psychological impact and impact on daily life), measured on a visual analogue scale (VAS) between 0 and 10, and a global score out of 100 was noted before embolization, after 3 months during the imaging follow-up, and at the end of follow-up by phone call. The main criterion was clinical efficacy of embolization defined by an impairment score < 40/100 and a 50% decrease in overall score. Complications were recorded. Visualization of Onyx® on MRI 3 months after embolization was noted.

Results

Between July 2017 and May 2019, 73 consecutive women (mean age ± SD [range]: 41 ± 11 years [25–77]) treated by embolization with Onyx® and Aetoxysclerol were included. The median follow-up was 28 months [Q1–Q3: 24.0–29.2] (range: 18.1–34.5). The median initial VAS impairment score was 39/100 [29.75–48.50] (12–58). Clinical efficacy was obtained for 70 patients (70/73, 95.9%), and the median VAS impairment score at the end of follow-up was significantly lower at 3 [0.00–7.25] (0–73) (p < 0.0001). Four minor complications occurred. Onyx® was visualized on DIXON sequence of MRI for all patients.

Conclusion

Embolization using Onyx® and Aetoxysclerol for PeVD is safe and effective.

Key Points

• Embolization using Onyx ® and Aetoxysclerol for pelvic venous disorders is safe and effective.

• Imaging follow-up is facilitated by visualization of Onyx ® on MRI DIXON sequences.

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Abbreviations

DMSO:

Dimethyl sulfoxide

Onyx® :

Ethylene vinyl alcohol copolymer

PACS:

Picture archiving and communication system

PCS:

Pelvic congestion syndrome

PeVD:

Pelvic venous disorders

SIR:

Society of Interventional Radiology

VAS:

Visual analogue scale

VVLL:

Varicose veins in the lower limbs

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Acknowledgements

Pippa McKelvie-Sebileau for medical editorial assistance in English.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France

    E. Jambon, Y. Le Bras, A. Coussy, F. Petitpierre, A. Lasserre, G. Cazalas, N. Grenier & C. Marcelin

  2. Pellegrin Hospital, Bordeaux, France

    H. Hans

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  1. E. Jambon
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Correspondence to E. Jambon.

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The scientific guarantor of this publication is Clément Marcelin.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

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Written informed consent was obtained from all subjects (patients) in this study.

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Institutional review board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported last year in Diagnostic and Interventional Imaging.

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Jambon, E., Le Bras, Y., Coussy, A. et al. Embolization in pelvic venous disorders using ethylene vinyl alcohol copolymer (Onyx®) and Aetoxysclerol: a prospective evaluation of safety and long-term efficacy. Eur Radiol 32, 4679–4686 (2022). https://doi.org/10.1007/s00330-022-08567-z

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