ArticleJournal of vascular surgery. Venous and lymphatic disorders2026
Endovascular reintervention versus conservative medical therapy for persistent or recurrent venous-origin chronic pelvic pain after primary ovarian vein embolization.
Article in Journal of vascular surgery. Venous and lymphatic disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aims to evaluate and compare the clinical effectiveness of endovascular reintervention vs conservative medical therapy in patients with persistent or recurrent venous-origin chronic pelvic pain (CPP) after initial endovascular embolization for pelvic venous disorders (PeVDs).
methodsWe retrospectively reviewed 79 patients with pelvic venous disorder and persistent or recurrent venous-origin CPP following primary ovarian vein embolization who subsequently received either reintervention (n = 40) or conservative medical therapy with venoactive drugs (n = 39). The primary endpoint was the 3-month CPP relief rate [Visual Analog Scale (VAS) reduction ≥2]. Secondary endpoints included longitudinal VAS score trajectories over 12 months. Inverse probability of treatment weighting was applied to balance baseline covariates, and outcomes were analyzed using weighted logistic regression and Linear Mixed-Effects Models.
resultsThe 3-month CPP relief rate was 67.50% (27/40) in the reintervention group and 35.90% (14/39) in the medical therapy group. After adjustment, reintervention group demonstrated significant overall superiority, with a more than threefold increase in the odds of 3-month CPP relief compared with medical therapy (odds ratio, 3.03; 95% confidence interval, 1.19-7.68; P = .022). The therapeutic advantage of reintervention was sustained through 12 months, with a significant group-by-time interaction (P < .001). Subgroup analyses showed no significant interactions for the 3-month CPP relief. However, significant interactions were observed for 12-month VAS improvement, with greater benefit from reintervention among patients initially treated at external institutions (P < .001) and those presenting with recurrence or partial relief (P < .001). No major procedure-related complications were observed during follow-up.
conclusionsEndovascular reintervention-based strategy is an effective option for persistent or recurrent venous-origin CPP after initial embolization. However, therapeutic benefit varies across patient subgroups, highlighting the importance of individualized patient selection.
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