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CVIR Endovascular: Women’s health in the spotlight

June 27, 2023

In an effort to raise the profile of women’s health, CVIR Endovascular Editor-in-Chief Prof. Jim Reekers invited Dr. Elika Kashef and Dr. Maria Tsitskari, two esteemed editorial board members, to guest edit the journal’s special issue dedicated to this important topic.

In an editorial, the guest editors looked back at the challenges the healthcare system faced 60 years ago. “The two-tier system of healthcare for males vs. females resulting in health inequities affecting individual health-seeking behaviour, poorer outcomes and delayed diagnosis, has long been recognised. This is a complex topic and the root cause of it is multifaceted, however, following the thalidomide scandal in the 1960s, there was a ban on pregnant women or women of child-bearing age partaking in any trials. Although this was aimed at protecting women, what it ended up doing was sidelining half the population from important clinical trials, which has led to poor recognition of disease patterns and worse outcomes for the female population.”

They reference a study on patients with chronic pain which concluded that doctors often view men with chronic pain as “brave” or “stoic,” but women as “emotional” or “hysterical.” The study also found that women’s pain was more likely to be treated as a symptom of a mental health condition, rather than a symptom of a physical condition.

While they acknowledge the challenges and systematic discrimination against women within the healthcare system, they also note that it has come a long way, and since 1993 women have been included in trials and studies globally. “As a result, we have emerging data on all aspects of pathologies that effect men and women, but also conditions that are specific to the female cohort.”

Drs. Kashef and Tsitskari commissioned four articles, which they say “will highlight how far we have come with common conditions affecting women.” This will hopefully not only demonstrate an exciting overview of results and outcomes to date, but also to inspire and motivate younger interventional radiologists to instigate and contribute to new trials and carry the banner for the next generation.

In the papers included in this edition, Drs. Mailli and Ratnam review the evidence for uterine artery embolization; Prof. Hemingway looks through the journey of treatments available for pelvic congestion syndrome; Dr. Roberts discusses fallopian tube recanalization techniques and outcomes; and Dr. O’Sullivan finishes the edition with review on deep venous stenting in women.

Drs. Kashef and Tsitskari meet to discuss the special issue.
CVIR Endovascular Editor-in-Chief Prof. Jim Reekers poses with Drs. Kashef and Tsitskari at CIRSE 2022.

Dr. Kashef and Dr. Tsitskari conclude their editorial with a call to action: ”In this post-pandemic era we should work together to elevate the importance of women’s health across the entire health industry. Women participating in studies should always be analysed also as a separate group, and differences in outcome between men and women should be taken seriously. Also, more studies focusing on women’s health issues should be undertaken. It is, for instance, now clear that coronary disease in women is sometimes completely different as in men. The lessons we have learned have the power to transform the future of healthcare and ultimately enable better care for women worldwide.”

A special thanks goes to the guest editors and to each of the authors who contributed their time and research! Enjoy browsing through this collection and sharing these articles with your colleagues!


Interventional radiology in woman’s health: room for improvement
Elika Kashef and Maria Tsitskari

Review Article
Uterine artery embolisation: fertility, adenomyosis and size – what is the evidence?
Leto Mailli, Shyamal Patel, Raj Das, Joo Young Chun, Seyed Renani, Sourav Das and Lakshmi Ratnam

Review Article
Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options
Elika Kashef, Elizabeth Evans, Neeral Patel, Deepsha Agrawal and Anne P Hemingway

Review Article
Fallopian tube recanalization for the management of infertility
Anne Roberts

Review Article
Deep venous stenting in females
Gerry O’Sullivan and Steven Smith

Dr. Elika Kashef is a consultant diagnostic and interventional radiologist at Imperial College NHS Trust with an interest in women’s health and fertility. Her professional focuses include pelvic congestion, pelvic ultrasound, transvaginal (internal) venous duplex studies for pelvic congestion and pelvic pain, imaging for infertility and benign gynaecological conditions.

Dr. Maria Tsitskari is a lecturer of radiology at the Medical School of European University, Cyprus, and a consultant of vascular and interventional radiology. Her science research has focused on the evaluation of the efficacy of new interventional techniques for the treatment of hepatic metastases in colorectal cancer patients.