Transvaginal glue embolization relieves persistent pelvic pain after failed transvenous treatment

Transvaginal embolization of residual pelvic varices reduced pain: median VAS at rest 4→1, activity 7→1, dyspareunia 8→2 (all p<0.001) at 12 months; CIVIQ-14 59.5→19. In 32 women after prior transvenous embolization. One asymptomatic glue embolus to lung, resolved.

• Technical success was 100%; 1-month transvaginal Doppler confirmed absence of residual pelvic varices.
• One asymptomatic proximal pulmonary glue migration (SIR grade 3) was successfully treated with catheter-directed thrombaspiration, with no clinical sequelae.
• Retrospective, single-center design in selected patients limits generalizability.

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