1. 下肢静脉曲张和盆腔静脉曲张(卵巢和髂内静脉)
(1)两者都治疗?还是分期治疗。
Should both OVs and the IIVs be embolized?
(2)先治疗哪一个?盆腔静脉曲张优先,还是下肢?或者没关系(does it matter?)
2. 影响生育吗?(Impact on fertility)
3. 关于卵巢静脉栓塞
(1)仅栓塞症状一侧,然后等着看(wait and see)
(2)最初就一侧性栓塞双侧卵巢静脉?
(3)球囊阻塞 vs 选择性导管?
(4)股,贵要和颈静脉途径?
(5)栓塞剂的选择
选择弹簧栓子、血管塞、液体硬化剂/ 类型? 液体栓塞剂 vs 泡沫硬化剂?硬化剂+明胶海绵?联合治疗(如硬化剂+弹簧栓子)
What embolization material should be used (coils, sclerosants, glue, or gelfoam)?
4. 关于髂内静脉栓塞
(1)治疗还是不治疗
(2)如果治疗,球囊阻塞还是选择性导管技术,路径如何?
(3)不治疗,等待卵巢静脉栓塞的临床反应
(4) 用硬化剂吗? 泡沫?硬化+明胶海绵?仅用弹簧栓子?联合治疗?
血管内栓塞导致PVD的临床改善(VAS评分),并没有关于不同方法的随机临床试验。SVP分类有助于前瞻性随机试验的设计和证据的产生。对于由May-Thurner 综合征(MTS)和胡桃夹综合征(NCS)引起的盆腔静脉疾病(PVD): 治疗潜在的解剖原因
- Consider the clinical background (limb varices)
- Embolise as many refluxing veins as possible
- Offer this treatment as the less invasive and the most effective one
What’s New In Pelvic Congestion?
• Continues to be haunted by lack high quality evidence
• No universally accepted dx criteria
• Roughly 75% patients symptomatic relief
• Aggressive interrogation of IIV’s
• Obstructive component more recognized
• No “best”
– Technique
– Embolic agent
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