LETTER TO THE EDITOR The Amplatzer Vascular Plug Also for Ovarian Vein Embolization Antonio Basile Æ Giuseppe Marletta Æ Dimitrios Tsetis Æ Maria Teresa Patti Received: 3 October 2007 / Accepted: 10 October 2007 Ó Springer Science+Business Media, LLC 2007 We read with interest the paper by Tuite and colleagues [1] regarding their retrospective review of 23 consecutive cases of vascular embolization using the Amplatzer Vas- cular Plug (AVP), a new self-expanding nitinol wire mesh vascular embolization device delivered and released only when satisfactorily positioned. The AVP is commonly used in place of coils. The most frequent complication of coil embolization is coil migration if there were some problem in choosing the right size; other less common complica- tions include erosion of the structures in which the coils are located, or infection [2, 3]. The standard treatment for female pelvic congestion syndrome is foam sclerotherapy into the ovarian vein below the level of the pelvic brim followed by coil embolization to within a centimeter of the vein origin [4, 5]. Commonly, due the fact that the ovarian veins are large, multiple coils are needed to complete the procedure, increasing the potential rate of the above-mentioned com- plications and the radiation exposure in young women. We treated a 39-year-old woman with pelvic congestion syn- drome using sclerotherapy plus proximal ovarian vein embolization with AVPs (Fig. 1). We found delivery of the system to be very safe and quick. We needed only two AVPs (12 and 14 mm) (Fig. 1) and the patient is symptom- free after 9 months of follow-up. Even though larger series and longer follow-ups are needed we think that AVP embolization could be used also in ovarian vein emboli- zation, partially obviating the limitations and complications of coil implantation and also reducing the radiation exposure in young women. To the best of our knowledge this is the first reported case of ovarian AVP embolization. References 1. Tuite D, Kessel DO, Nicholson AA, et al. (2007) Initial clinical experience using the Amplatzer vascular plug. Cardiovasc Inter- vent Radiol 30:650–654 2. Yoon JW, Koo JR, Baik GH, et al. (2004) Erosion of embolization coils and guidewires from the kidney to the colon: Delayed complication from coil and guidewire occlusion of renal arterio- venous malformation. Am J Kidney Dis 43:1109–1112 3. Falagas ME, Nikou SA, Siempos (2002) II: Infections related to coils used for embolization of arteries: Review of the published evidence. J Vasc Interv Radiol 13:935–938 4. Venbrux AC, Chang AH, Kim HS, et al. (2002) Pelvic congestion syndrome (pelvic venous incompetence): Impact of ovarian and internal iliac vein embolotherapy on menstrual cycle and chronic pelvic pain. J Vasc Interv Radiol 13:171–178 5. Nicholson T, Basile A (2006) Pelvic congestion syndrome: Who should we treat and how? Techn Vasc Interv 9:19–23 A. Basile (&) Á M. T. Patti Department of Diagnostic and Interventional Radiology, Ospedale Ferrarotto, via Citelli 14, 95124 Catania, Italy e-mail: antodoc@yahoo.com G. Marletta Department of Vascular Surgery, Ospedale Ferrarotto, via Citelli 14, 95124 Catania, Italy D. Tsetis Department of Radiology, University Hospital of Heraklion, Medical School of Crete, Heraklion, Greece 123 Cardiovasc Intervent Radiol DOI 10.1007/s00270-007-9235-y