OVARIAN VEIN COILING

Ovarian vein coiling is a minimally-invasive day procedure for the treatment of varicose veins of the pelvis.

Incompetent (leaking) ovarian veins can cause the formation of varicose veins in the pelvis. This can lead to the formation of varicose veins in the legs over time (via connections between veins in the pelvis and veins in the legs), and also aching in the pelvis (pelvic congestion syndrome).

Ovarian vein coiling involves deployment of metallic coils in to one or both of the ovarian veins to block them off and prevent leaking in to the veins in the pelvis. The procedure is combined with sclerotherapy for the varices in the pelvis. It is usually used as a 'first-step' for the treatment of varicose veins in the legs when pelvic varices are found to be the underlying cause. The 'second-step' is usually minimally-invasive treatment for the varices in the legs (e.g. Radiofrequency Ablation).

The treatment is contraindicated during pregnancy.

Preparing for the Procedure:

The procedure is performed under local anaesthetic and sedation. Following sedative medication, you will need someone to drive you home after treatment.

No other special preparation is required.

Description of the Procedure:

The procedure is performed under X-ray guidance, via ultrasound-guided needle access to the femoral vein in the groin (usually on the right). Once the vein is accessed, a sheath is inserted and venography (injection of dye in to the veins) is performed through a catheter to reveal precise anatomy under X-ray. This allows location of the ovarian vein to be treated.  A combination of wires and catheters is then used to access the ovarian vein for treatment. Coils are deployed in to the diseased vein via a catheter. After deployment, some sclerosant is injected in to the ovarian vein, which drains down in to the pelvic varices.

After treatment, all wires and catheters are removed, and the sheath is removed from the femoral vein. Digital pressure is applied to the vein in the groin for a few minutes for haemostasis.

Following the Procedure:

It is important to walk regularly in the days following the procedure. Avoid standing still for prolonged periods.

You will be scheduled for a review appointment with Mr Milne after 3 weeks.

Travelling:

You may travel short distances, under 4 hours, 2 weeks following the procedure. It is ideal to avoid flights/train/car travel over 4 hours duration for 4 weeks following the procedure. It is important to stay hydrated and walk around the cabin regularly whenever flying.

 

Possible Issues Following the Procedure:

- Discomfort/bruising:

• Some mild discomfort and bruising can occur in the groin following the procedure, but this normally settles within a few days
• Uncommonly, you can experience some mild discomfort in the lower abdomen associated with the treatment of the pelvic varices. This should also settle over a few days. If it doesn't settle, you should contact the office and we will arrange for an ultrasound to check on the main veins in the abdomen.

- Bleeding:

• Some ooze from the groin can occur in the first few hours following treatment
• This is not dangerous. It should stop by lying down with the legs up and applying gentle pressure to the groin.
• If persistent, you should contact the office and we will arrange to review the groin

- Deep vein thrombosis (DVT)

• Rare (<1% of cases)
• If this occurs, a course of oral anticoagulation is prescribed with a follow up ultrasound

- Very rare complications (<0.5% of cases):

• Infection
• Allergic reaction/anaphylaxis

- Recurrent veins (in the years following the procedure)

• Recurrent varicose veins occur in ~20% of patients in the 5 years following treatment for varicose veins
• If this occurs, a repeat ultrasound scan can be performed to determine the nature of recurrence and best treatment option

Return to the Varicose Veins Home Page to learn about other treatment options.