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All Journal Syifa' MEDIKA: Jurnal Kedokteran dan Kesehatan Health and Medical Journal
Hamisi, Andy A.
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Pelvic Congestion Disease with Amplatzer Vascular Plug Embolization: A Case Report Hamisi, Andy A.; Tjandra, Djony E.; Khosama, Yuansun
Syifa'Medika Vol 16, No 2 (2026): Syifa Medika: Jurnal Kedokteran dan Kesehatan
Publisher : Faculty of Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32502/sm.v16i2.10665

Abstract

Pelvic congestion disease is a prevalent condition causing chronic pelvic pain in women, primarily due to venous insufficiency in the pelvic region. Endovascular embolization, particularly using the Amplatzer Vascular Plug (AVP), has emerged as an effective therapeutic option for treating PCD. This case report presents a 34-year-old female with chronic left lower abdominal pain, diagnosed with PCD and successfully treated with AVP embolization. Preoperative diagnostic imaging, including multislice computed tomography (MSCT) and venography, identified left ovarian vein reflux. Following embolization, the patient showed significant symptom relief, with no recurrence during follow-up. Literature indicates that embolization, particularly with AVP, offers superior occlusion and fewer complications compared to traditional coil embolization. The procedure is minimally invasive, with low complication rates, and offers durable long-term results. Despite the effectiveness, there is a need for improved standardization in treatment protocols and classification systems to optimize PCD management. The SVP classification system provides a useful framework, but a more management-oriented approach is necessary for tailored treatment planning.
Arteriovenous Fistula Intervention on Snuffbox Area: A Systematic Review Hamisi, Andy A.; Khosama, Yuansun; Tjandra, Djony E.
Health and Medical Journal Vol. 8 No. 2 (2026): May 2026
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33854/heme.v8i2.2093

Abstract

The anatomical snuffbox arteriovenous fistula (ASB-AVF) is the most distal upper-extremity configuration for haemodialysis access and fits well with distal-first, vessel-preserving strategies, yet its clinical adoption remains limited despite endorsement as a first-line option in anatomically suitable patients. This systematic review, conducted according to PRISMA guidelines, used PubMed, the Cochrane Library, and Google Scholar to identify English-language human studies on ASB-AVF published between 1 August 2024 and 2 October 2025, using combinations of “snuffbox,” “fistula,” and “distal-radial” as search terms. Eligible studies were assessed for anatomical criteria, patency, complications, and clinical implementation, and interpreted within five conceptual frameworks: distal-first/vascular access preservation, haemodynamic optimisation, hand ischaemia and complication minimisation, patient-centred vascular access care, and access lifecycle theory. Overall, the literature indicates that ASB-AVF can achieve high early and long-term patency rates (around 84.6–>90%) while preserving proximal radial segments, reducing tissue trauma, and minimising complications such as steal syndrome and neo-intimal hyperplasia. Outcomes are strongly influenced by vessel calibre, comorbidities (especially diabetes and peripheral arterial disease), and operator expertise. Barriers to broader use include small, heterogeneous cohorts, technical complexity, dependence on ultrasound-guided access, and surgeon familiarity with conventional wrist or upper-arm AVFs. Standardised training, refined selection tools, and personalised nursing strategies represent key opportunities to optimise results and support ASB-AVF as a feasible first-line option in selected patients.
Co-Authors Tjandra, Djony E. Yuansun Khosama, Yuansun