Pelvic Vein Embolisation
Pelvic Vein Embolisation is a minimally invasive procedure which has been performed for over 20 years. It has been advocated for the treatment of “Pelvic Venous Congestion Syndrome” and more recently adopted for the management of pelvic vein reflux associated with leg varicose veins (particularly where previously ‘treated’ varicose veins have recurred) although there is a lack of robust level I evidence for either indication.
A ‘pinhole’ surgical technique, it is performed under local anaesthesia and usually mild sedation. A fine catheter is inserted into the vein behind the collar bone and directed to the incompetent veins. As with the leg vein surgery, only the abnormal veins are destroyed leaving normal healthy veins to carry blood away from the pelvis. Recovery from the procedure is rapid and return home is encouraged after a short bed rest. Normal activity can be commenced within 24 hours.
Minimum Standards for Pelvic Vein Embolization
Dr Lopez has established himself as one of the most experienced specialists performing this procedure in the UK and, from available published data, is one of the most experienced practitioners in the world including Europe & the US. As such, he is well placed to help determine the minimum recommended standards for safely and successfully performing this specialist proecdure:
- The procedure should be performed within a hospital environment using facilities certified by the Care Quality Commission (CQC) and employing specialist interventional radiology equipment certified by an accredited radiation protection supervisor.
- The operating room ideally should have laminar air flow, since a prosthesis is being introduced and, rather like a joint replacement, infection should be avoided
- The imaging equipment used must have its dose monitored regularly by a Radiation Protection Supervisor (RPA) who is typically a physicist. At The Imaging Clinic, the radiation dose is consistently low.
- It is highly recommended that the entire procedure is performed under conscious sedation using a mild intravenous hypnotic agent and narcotic analgesic, as the sclerotherapy component of the procedure uses an irritant ‘foam’ which is intensely uncomfortable, but felt by Dr Lopez to be essential
- Sedation will ensure comfort throughout the entire procedure which should take less than 60 minutes (for up to four veins) yet enable the patient, who typically sleeps throughout, to be roused easily at the end followed by rapid ‘recovery’
- A ‘hospital’ environment is important as there is easy access to aneasthetists and other colleagues if necessary. It also alows a suitable area for recovery in a comfortable bedroom for this ‘day case’ procedure during a 5-6 hour admission
You are strongly advised to specifically ask any institution contemplating this procedure whether it us fulfilling the above criteria for the minimum standards suggested by one of the world-leading authorities on this specialist procedure.
Dr Lopez has published widely on this procedure and is invited regularly to present his work at leading UK, other European & US interventional radiology & surgery conferences. He has spent considerable time teaching interventional radiology & surgical colleagues from many parts of Europe including France, Holland, Ireland, Italy and Portugal, including interactive ‘live case’ teaching.
- Pelvic vein embolisation in the management of varicose veins
- Female pelvic vein embolization: indications, techniques and outcomes
He has also made a number of appearances in health documentaries on National & International television including:
The Learning Channel’s My Naked Secret (“Pam’s Story)
Dr Lopez & The Imaging Clinic are recognised by ALL private medical insurance companies. There is no reason whatsoever that an insured patient needs to pay for this procedure assuming that the clinical indication is agreed by the insurance company, notwithstanding any co-payment or excess associated with some policies. Furthermore, The Imaging Clinic can offer competitive self-funding rates for self-funding patients, and offers a number of locations to perform the procedure.
Dr Lopez receives referrals from surgeons, gynaecologists and other physicians Nationally and Internationally. Patients requiring the procedure are encouraged to contact The Imaging Clinic directly so we can make the necessary arrangements and ensure that the surgeon performing any subsequent vein procedures receives all the operative notes and ‘xray’ images on CD ROM, immediately following the embolisation.
The Imaging Clinic and its radiologists are recognised by all medical insurers and unless otherwise requested, invoices are submitted directly to them using electronic software, and are usually settled directly. As usual, you are advised to contact your insurance company prior to receiving treatment.
A competitive self-funding package (fully inclusive of hospital and consultant fees) is also available:
Treatment of one refluxing pelvic vein using foam sclerotherapy alone £1700
Treatment of 2-4 refluxing pelvic veins using foam sclerotherapy alone £1920
Your Consultant will advise you if your treatment will require placement of coils as part of an embolisation procedure. These specialist prostheses are made of platinum and charged at £175 each, with a typical requirement of approximately four coils for the longer larger ovarain veins and three coils for the smaller internal iliac (hypogastric) veins.
A full written quotation will be provided and original printed receipts made available following treatment as required.
The Imaging Clinic currently performs the procedure in Guildford, with day care provided by Nuffield Health (Guildford).
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