TORONTO - Coils combined with a foam sclerosing agent can effectively treat painful varicose veins in places other than the legs, according to researchers Friday at the Society of Interventional Radiology (SIR) meeting.
Dr. Robert White Jr., a professor of diagnostic radiology at Yale University in New Haven, CT, reported on his group's efforts with embolotherapy with pushable fibered coils and sodium tetradecyl sulfate (STS). They treated 25 patients with this technique: 16 men with varicocele and nine women with pelvic congestion syndrome (PCS).
Varicocele, or enlarged veins in the scrotum, occurs in about 10% of males, White said. In about 20% of men, varicocele can cause infertility. In women, PCS can cause the internal ovarian veins to fail and result in blood pooling in the pelvis.
For the varicocele technique, a fluoroscopy-guided catheter was used to enter the internal spermatic vein. The sclerosing coils were placed at strategic points in the vein, and the spaces between the coils were filled with 3% STS foam. White reported technical success in 15 of the 16 cases.
For PCS, catheterization of the left ovarian vein was performed in the same way but without compression. Of the nine women, six reported marked improvement after treatment, according to White.
A major advantage of this type of embolotherapy is that the foam blocks off numerous collateral veins as well as the main enlarged vein. In Europe and Canada, this minimally invasive technique is used quite often, although it is less common in the U.S. because of reimbursement issues, White said.
The technique has particular value in PCS, a condition that is underdiagnosed and undertreated, White noted. Many women undergo hysterectomy for PCS, but that the latter procedure fails in 25% of cases, he said.
However, White acknowledged that more studies with a higher number of patients were still needed, especially with PCS.
Still, interventionalists are optimistic that the procedure will gain acceptance with clinicians and patients, particularly when "pelvic floor syndromes and pain bedevil the primary care physician," commented Dr. Robert Vogelzang, chief of interventional radiology at Northwestern Memorial Hospital in Chicago.
By Edward Susman
AuntMinnie.com contributing writer
March 31, 2006
Related Reading
Scrotal ultrasound detects obstructive azoospermia, March 30, 2006
Studies bolster sonography's value for abnormal gynecological bleeding, November 5, 2004
Study outlines sonographic findings of pelvic congestion syndrome, April 14, 2004
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