Embolization Strategies for Pelvic Venous Disorders: Foam + Glue vs Foam + Coils

Inclusion Criteria * Female patients aged 18 to 50 years * Clinically suspected pelvic venous disorder (PVD), presenting with chronic pelvic pain ≥ 6 months * Pelvic pain intensity ≥ 4 on a 10-point Visual Analogue Scale (VAS) at baseline * No evidence of significant venous obstruction or internal iliac insufficiency * Willingness to participate, provide written informed consent, and comply with study visits and procedures exclusion criteria * Pregnancy or planning to conceive within the next 12 months * Significant Nutcracker syndrome diagnosed by duplex / CTV / MRV * Significant May-Thurner syndrome diagnosed by duplex / CTV / MRV * Non-ovarian sources of reflux requiring intervention, including internal iliac vein insufficiency; During venography all patients will undergo selective pelvic venography prior embolization to exclude patients who have combined gonadal and internal iliac vein reflux) * History of previous pelvic vein embolization or surgical ligation * Coagulopathy, defined as: * INR \> 1.5 * Platelet count \< 50 × 10⁹/L * Severe comorbidities, including: * Active pelvic infection (e.g., pelvic inflammatory disease) * End-stage renal disease (eGFR \< 30 mL/min/1.73 m²) * Decompensated heart failure (NYHA class III-IV) * Active malignancy requiring treatment Known allergy or hypersensitivity to: * Iodinated contrast media * Polidocanol (Aethoxysklerol®) * N-butyl cyanoacrylate (e.g., Gluebran® 2) * Nickel, platinum, or stainless steel (components of embolization coils) . Presence of non-venous pelvic pathology requiring immediate management