Techniques and Clinical Outcomes of Catheter-Directed Sclerotherapy Using Ethanol for Ovarian Endometriomas

Chu Hui Zeng, Ji Hoon Shin
In: Journal of the Korean Society of Radiology · 2025 · vol. 87(3) , pp. 487 · doi:10.3348/jksr.2025.0021 · W4412447689
article OA: diamond CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper describes catheter-directed sclerotherapy using ethanol for ovarian endometriomas, demonstrating its effectiveness in reducing cyst volume and preserving ovarian reserve compared to surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This pictorial essay describes catheter-directed sclerotherapy using 99% ethanol for ovarian endometriomas, focusing on practical procedural steps and reported clinical outcomes. The paper summarizes high-level methods for transvaginal (preferred) or transabdominal access, including catheter placement over a guidewire, aspiration and irrigation of chocolate-colored cyst contents, contrast instillation to check for leakage, then ethanol instillation with interval patient repositioning, with a two-session overnight option and interruption if significant pain or contrast spillage occurs. Reported technical success is cited as up to 100%, with cyst volume reductions (e.g., an average volume reduction ratio of 96.4% at 6 months) and relative preservation of ovarian function based on stable serum anti-Müllerian hormone levels, including in patients with diminished reserve or recurrence, while noting that success may be slightly lower for two-session procedures. This paper is centrally about endometriosis—specifically ovarian endometriomas—and details ethanol catheter-directed sclerotherapy techniques and outcomes.

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Abstract

Although medical therapies and surgical cystectomy are common treatments for ovarian endometriomas, recurrence and ovarian reserve decline remain concerns.Catheter-directed sclerotherapy is a promising alternative because the use of large-bore catheter allows improved cyst content aspiration, making sclerotherapy more effective.The procedure is typically performed transvaginally, and transabdominal access is considered when transvaginal access is not applicable.According to previous reports, this technique demonstrates high technical success and results in a meaningful reduction in cyst volume and better preservation of the ovarian reserve compared with surgery.Recurrence rates also tend to be lower.This pictorial essay presents the catheter-directed sclerotherapy technique and typical cases using this technique, both transvaginally and transabdominally.

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