Trial of Ovarian Vein and Pelvic Vein Embolization in Women With Chronic Pelvic Pain and Pelvic Varices

Inclusion Criteria: 1. Presence of venous origin chronic pelvic pain for greater than 6 months (VAS ≥7 as determined by 4 consecutive weeks of baseline self-assessments) despite non-vascular therapy as delineated by the following criteria: * Pain exacerbated by walking, standing or lifting * Symptoms are at least partially alleviated by lying down * Prolonged post-coital ache * Absence of non-venous origin CPP as determined by Gynecology examination 2. Symptoms-Varices-Pathophysiology Classification18 including of one of the following: •S2V2PBGV,R,NT, S2V2PRGV,R,NT , S2V2PLGV,R,NT, with or without S2V2 PBIIV,R,NT, S2V2 PLIIV,R,NT, S2V2 PRIIV,R,NT 3. CT, TAUS and diagnostic venography (if needed) imaging review for pelvic venous imaging factors * Left or right ovarian vein diameter greater than or equal to 6 mm as documented by TAUS or CT * Presence of intrabdominal/pelvic varices as documented by TAUS or CT (≥1 veins, \>5 mm diameter) * Presence of venous reflux in ovarian and/or internal iliac veins without evidence of hemodynamically significant stenosis Exclusion Criteria: * Female \<18 years of age * Pregnancy (positive pregnancy test) * Female subject who plans to become pregnant during study period * Female subject who is actively breastfeeding * Patient who is post-menopausal or anovulatory with hormone suppression * History of prior hysterectomy * Prior ovarian vein embolization or ovarian vein ligation * Inability to tolerate endovascular procedure due to acute illness or general health * Planned simultaneous treatment with nerve blocks during the duration of the study * Laparoscopy or planned surgical intervention during the duration of the study * Known allergy to sclerosant, coil, stent or catheter components including nickel allergy * Any iliac vein stenosis determined identified by the investigator on pelvic DUS, CT venogram, and/or Catheter Venography and deemed significant for exclusion by study patient review committee. * Any renal vein stenosis with resultant renal hilar varices/collaterals and lumbar collaterals identified by the investigator on pelvic DUS, CT venogram, and/or Diagnostic Venography and deemed significant for exclusion by study patient review committee. * Presence of isolated extra-pelvic vulvar and/or lower extremity varices without intrabdominal pelvic varices. Primary S3 categorization study exclusion. * Serious medical conditions that might preclude full participation in the study to the desired endpoint (e.g., uncontrolled diabetes, malignancy, COPD, MI, CHF, etc.) * Severe allergy to iodinated or gadolinium-based contrast refractory to steroid premedication * Severe renal impairment (on chronic dialysis or estimated GFR \<30 mL/min) * Hemoglobin \<8.0 g/dL, uncorrectable INR \>3.0 or platelet count \<75,000/microliter * Inability to provide informed consent or to comply with study assessments * Post thrombotic IVC, iliac or ovarian vein changes