Endovascular treatment of pelvic congestion syndrome (2024 – CME) – online course
Description
Authors: A. Basile and D. Castiglione
Reviewers: M. Das, R. Hoffmann, L. Marques, B. Peynircioglu and R. Uberoi
This course corresponds to chapter 2.2.1.3.5 Gonadal venous interventions in the European Curriculum and Syllabus for IR.
Abstract
Pelvic congestion syndrome (PCS) represents a complex condition known to cause chronic pelvic pain in up to 40% of women who are referred to a gynaecologist due to noncyclic pelvic pain persisting for more than six months, occurring throughout the menstrual cycle, and unrelated to pregnancy. The main features of PCS include the presence of venous insufficiency and varicosities in the pelvic venous plexus. It is essential to exclude other pathologies such as endometriosis, fibroids, or AVM because symptoms may overlap.
Clinical assessment and diagnosis may be challenging, and the role of imaging is helpful in characterising varicosities and venous insufficiency to support the diagnosis and treatment planning.
Transcatheter embolization of ovarian or internal iliac veins has been demonstrated to be effective in PCS management, especially combined with medical therapy, and it is associated with relatively low complication rates. However, there is no consensus regarding the target of the embolization. Some authors suggest unilateral or bilateral gonadal vein embolization, while others recommend embolization of the internal iliac veins. The most commonly used embolization technique includes the use of coils, coils plus sclerosant, or plugs. Outcomes reported in several studies have documented a reduction in pain, discomfort, dyspareunia, dysmenorrhea, and the use of analgesic medications, with 50-80% of women exhibiting clinical improvement at long-term follow-up.
Embolization of gonadal or internal iliac veins is a safe treatment option that leads to a substantial improvement in quality of life and symptom control, with low rates of serious complications. It is considered the treatment of choice for PCS due to its high efficiency and low invasiveness.
Learning objectives
- To be aware of the different possible causes of pelvic pain in women
- Understand relevant vascular anatomy of the ovarian vein and internal iliac vein plexus interconnection
- Describe the pathophysiology of the disease
- Recognise imaging criteria for diagnosis of pelvic congestion syndrome
- Understand the indications and contraindications of the treatment’s technique
- Achieve a basic understanding of the embolization technique in pelvic congestion syndrome
- Learn about post-procedural management and follow-up
- Illustrate outcome data from literature
Further information
This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 2.2.1.3.5 Gonadal venous interventions.
The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around 1.5 hours and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1.5 European CME credits (ECMEC). The CME accreditation for this course will expire on July 31, 2026. A non-CME accredited version of the course will remain available until July 31, 2028.
The acquired CME Certificate will be available in the myCIRSE area under CIRSE Academy.
The enrolment period of this course is linked to the validity of the All-Access Pass.
Release date: July 2024
