PVE is performed under local anesthesia with light sedation, making it a safe and comfortable option for many women. You may be an ideal candidate if you have:

• Pelvic varicose veins caused by reflux in the ovarian or internal iliac veins
• Pelvic vascular malformations that are difficult or risky to remove with open surgery
• Persistent symptoms of Pelvic Congestion Syndrome (PCS) such as chronic pelvic pain or heaviness that have not improved with medications

This procedure is especially suited for women seeking a minimally invasive alternative to surgery with faster recovery and long-term relief.

Before the procedure, a pre-assessment consultation (often via phone) is arranged. Key preparation steps include:

• Eating & drinking: No solid food 6 hours before; water allowed until 2 hours before.
• Medications: Continue regular medicines unless taking blood thinners—these may need to be stopped temporarily.
• Pregnancy: PVE is not performed if you are pregnant or breastfeeding. A pregnancy test will be done on the day of your procedure.

The procedure is carried out by an interventional radiologist in the radiology (X-ray) department.

• You will be asked to lie flat on your back on the X-ray table.
• Monitoring devices will be attached to your chest and finger to track your heart rate, blood pressure, and oxygen levels.
• A small plastic tube (cannula) will be placed into a vein in your hand or arm.
• If needed, a sedative injection will be given through this cannula to help you relax.
• The team will wait for the sedative to take effect before starting.
• If required, extra oxygen will be provided via small tubes placed in your nose.

Local Anesthesia & Access Site:

• The skin on your neck will be cleaned with antiseptic and covered with a sterile drape.
• A local anesthetic injection will be given to numb the area (this may sting briefly).
• A small needle will then be inserted into a neck vein.
• A thin guide wire will be passed through the needle into your vein.
• The needle is then withdrawn, and a fine plastic tube (catheter) is placed over the wire into the vein.
• Using X-ray guidance, the radiologist moves the catheter into the abnormal pelvic veins.

Contrast Injection:

• A special X-ray dye (contrast medium) is injected into the catheter.
• This helps highlight the abnormal veins on the X-ray.
• You may feel a brief warm or hot sensation in your pelvis when this happens, but it passes quickly.
• Once the faulty veins are located, the radiologist inserts tiny coils and/or sclerosant foam through the catheter.
• These materials seal off the abnormal veins completely, stopping reflux.

Completion:

• The catheter is removed.
• Firm pressure is applied to your neck for a few minutes to prevent bleeding and close the vein entry point.
• If you feel pain at any point, pain relief medication can be given through your cannula.

Duration:

• The embolization itself usually takes around 30 minutes.
• In more complex cases, it may take up to 1 hour.
• Overall, expect to spend 2–4 hours in the radiology department, including preparation and recovery time.

• Mild pressure or warmth as the dye passes through the veins
• Minimal discomfort at the puncture site (managed with local anesthesia)
• If sedation is used, you will feel relaxed and drowsy, but not unconscious
• Afterward, some pelvic or lower back soreness is normal and can be managed with pain relief tablets
• Most patients resume normal light activity within 3–5 days and feel progressive symptom relief over the next 1–3 months.

• Expect mild pelvic pain or cramps for a few days, easily managed with oral painkillers.
• Avoid heavy lifting or intense exercise for 7–10 days.
• Follow-up imaging (usually an ultrasound scan) and consultation will be scheduled 2 months later to confirm success.