This page contains links to the documented side effects associated with Ovarian Vein/Pelvic Vein Embolization (both during the procedure, and post-procedure). I've also included links of reported issues and complications relating to male gonadal vein embolization.
The list is a compilation of articles, forum discussions and journals (where possible I've linked to medical journals).
Documented Complications and Side Effects:
During the procedure:
Coil Migration:There have been cases recorded of coil migration during the procedure (this was one of the risks my doctor discussed with me prior to having the procedure). Some of the cases are documented in the following articles and medical journals:
- Unintended coil migration into the right ventricle during the right ovarian vein coil embolization
- Pulmonary Embolism due to Metal Coil Migration After Treatment of Pelvic Varices
- This article discusses a case of a patient who underwent a pelvic
vein embolization to treat pelvic congestion syndrome. A CT scan was
performed 15 years later, which showed a coil situated in the "segmental
pulmonary
artery of the left lower lobe".
- Migration to the pulmonary artery of nine metallic coils placed in
the internal iliac vein for treatment of giant rectal varices - This journal article reports the case of a male patient who underwent internal iliac vein coil embolization. the authors reported that "nine coils migrated into the pulmonary artery". - Embolization Coil Migration: An Unusual Cause of Pulmonary Embolism - this journal article describes coil migration experienced by a male patient who had previously undergone bilateral gonadal vein coil embolization.
There have been cases recorded where the coils or foam have accidentally been misplaced, as described in the following articles:
Radiation Exposure to the Ovaries:
The procedure involves the use of fluoroscopy.
A doctor who is experienced in performing the procedure wrote the following about the radiation dose of the procedure:
"...The mean of these measurements (considering the number of veins embolized and given the degree of difficulty varies between patients) is 5200 cGy/cm2 which converts to an effective dose of approximately 6 mSv.
What does this mean in ‘real’ terms? This is equivalent to a CT scan of the abdomen and pelvis using a modern 128 multislice CT scanner at the same hospital.
Alternatively, it equates to 3 years of ‘natural’ background radiation—we are all exposed to background radiation from the surroundings including the sun—(or 1 year of background radiation in some parts of the West of England, e.g. Cornwall).
Source: 'Female Pelvic Vein Embolization: Indication, Techniques, and Outcomes', Anthony James Lopez , 2015For UK patients, an alternative equivalent would be a return flight to Paris. The conversion is 0.0011 mSv per cGycm2, i.e. multiply the DAP by 0.0011 to get the effective dose (NB it will vary with the size of the patient and the software assumes rectangular collimation rather than the near circular image intensifier field)."
Following the procedure:
Please note, some patients have experiences symptoms/problems immediately following the procedure, whereas other have been symptom-free for months or years before experiencing problems.
Abnormal Uterine Bleeding
This article discusses a patient who developed abnormal uterine bleeding following the procedure. The authors concluded that:"The use of ovarian vein embolization for treatment of pelvic congestion syndrome may be associated with abnormal uterine bleeding."
and
"Our advice is to counsel patients before ovarian vein embolotherapy about the possibility of abnormal uterine bleeding as a complication of the procedure. The procedure is relatively new and still evolving and other complications may be encountered in the future. Patients should be aware of this at the time of informed consent"
(Mostafa A. Borahay et al./Asian Pacific Journal of Reproduction (2012)60-62)
Metal Allergy
There are cases of patients experiencing symptoms associated with metal allergy following vein embolization. Here are a couple of recorded cases:
- Hypersensitivity to nickel in a patient treated with coil embolization for pelvic congestion syndrome - this patient experienced symptoms associated with metal allergy and testing confirmed a hypersensitivity to nickel and palladium. She had the coils removed and her symptoms resolved.
- MELISA Diagnostics have recorded several cases of patients experiencing metal allergy due to coils, whose symptoms have resolved following coil removal
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