Quarterly update
with Social Media Editor Sara Lojo
Dr. Sara Lojo is passionate about interventional radiology and has been involved in the editorial board of many publications since her training. She considers editorialism to be a fundamental tool for training, encouraging its development and bringing it closer to the new generations of IR professionals.
In this Quarterly Update, she will highlight key issues in IR and accompanying CVIR Endovascular articles on the topic.
Dr. Sara Lojo is passionate about interventional radiology and has been involved in the editorial board of many publications since her training. She considers editorialism to be a fundamental tool for training, encouraging its development and bringing it closer to the new generations of IR professionals.
In this Quarterly Update, she will highlight key issues in IR and accompanying CVIR Endovascular articles on the topic.
Quarterly Update #9: Pelvic congestion syndrome
Published on December 2025
Pelvic congestion syndrome (PCS) is a chronic condition caused by venous insufficiency within the ovarian and pelvic venous plexuses, leading to pelvic pain, heaviness, and dyspareunia, typically in multiparous women. The pathophysiology involves venous reflux, dilatation, and impaired drainage of the gonadal and internal iliac veins. In men, a similar mechanism underlies varicocele, which may present with scrotal pain, infertility, or testicular discomfort.
Over the past decade, endovascular therapy has emerged as the preferred minimally invasive treatment for these venous disorders. Embolization of refluxing gonadal or pelvic veins aims to relieve symptoms by occluding incompetent venous channels and redirecting flow toward healthy pathways. A range of embolic agents—including coils, plugs, liquid embolics, and, more recently, shape-memory polymers—have been explored to improve technical success and durability while minimizing complications.
The journal CVIR Endovascular has published a consistent body of work addressing different aspects of PCS and gonadal vein interventions. Recent reviews have outlined diagnostic criteria, patient selection, and procedural strategies for female venous congestion syndromes, while technical case reports have highlighted innovative materials and access approaches, such as polymer devices for patients with metal allergies or antegrade embolization techniques for recurrent varicocele.
In addition, retrospective series have examined long-term outcomes, recurrence rates, and embolic agents in varicocele treatment, providing valuable real-world data. Other contributions have analyzed Nutcracker syndrome in relation to PCS, exploring how renal vein compression can exacerbate pelvic venous reflux and influence treatment planning. The journal has also expanded the discussion to deep venous stenting in women and the broader role of interventional radiology in female venous disease, emphasizing multidisciplinary care and patient communication, including an evaluation of the quality of online health information regarding pelvic vein embolization.
Together, these publications reflect the growing maturity of endovascular management of pelvic venous disorders within the interventional radiology community. They illustrate not only the technical evolution of embolization procedures but also the parallel attention to patient experience, education, and the integration of IR into comprehensive women’s health care.
Articles
Elika Kashef, Elizabeth Evans, Neeral Patel, Deepsha Agrawal & Anne P Hemingway
Shape memory polymer ovarian vein embolisation in a patient with nickel allergy
Davide Castellano, Andrea Boghi, Luca Di Maggio, Alessandro Rapellino & Daniele Savio
R. J. Lee, D. C. O’Neill, M. Brassil, J. Alderson & M. J. Lee
Antegrade embolization of varicocele with cyanoacrylate glue: a case report
Thomas Le Tat, Raphaël Jost, Clément Hanotin, Alexandre Lucas, Liess Laouisset, Antoine Hakime & Viseth Kuoch
Meadhbh Ni Mhiochain de Grae, Maha Al-khattab, Amor Alkadhimi, Maia Springael & Gerry O’Sullivan
Treatment rationale in nutcracker syndrome with concurrent pelvic congestion syndrome
Dominik A. Steffen, Arash Najafi, Georgios Festas & Christoph A. Binkert
Controversies in treating nutcracker syndrome
Vitorio Perić, Thomas Ferenc, Tomica Bratić, Jana Bebek, Ivan Antun Mašić, Filip Ferega, Vid Vrčić, Danko Milošević, Helga Sertić Milić & Vinko Vidjak
Read more Quarterly Updates
Quarterly Update 8: Clinical Management
Quarterly Update 7: Lymphatics
Quarterly Update 6: Venous Thrombosis
Quarterly Update 5: Sustainability in IR
Quarterly Update 4: Complications in IR
Quarterly Update 3: Paediatric interventions
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