ObjectiveThis study aimed to evaluate the effectiveness and safety of coils plus glue in slope embankment technology versus coils plus sclerosant in treating reflux-type pelvic venous disorders. MethodsThe analysis included patients diagnosed with reflux-type pelvic venous disorders who were treated with coils plus glue (CPG) or coils plus sclerosant (CPS) from 2019 to 2021. The inclusion criteria were non-cyclic pain lasting more than 6 months, atypical varicose, and transvaginal Doppler ultrasonography (TVDUS) and computed tomographic venography(CTV) confirming the diagnosis and excluding compression factors and other diseases. Propensity score matching was performed at a 1:1.1 ratio based on the following covariates: age, pregnancy, BMI, pretreatment VAS, dysmenorrhea, dyspareunia, urinary urgency, tenesmus, low back pain, vulvar varicosities, vaginal varicosities and lower limb varices. The pain was relieved by embolizing the target lesions with different embolic materials. The efficacy and safety of the different embolization materials were compared by visual analog scale (VAS) and TVDUS examinations at 1, 3, 6, 12, 24, and 36 months. ResultsFrom a total of 495 patients, 88 patients were selected from the CPG group and 77 patients from the CPS group by propensity score matching. The patients were followed up for 36 months. The preoperative VAS score of the Coils Plus Glue(CPG)group was 8 (range 6-8), and the Coils Plus Sclerosant(CPS) score was 8 (range 7-8),P=0.64. The post-embolization VAS score of the CPG group was 2.05±0.37, and the CPS score was 2.14±0.35(P=0.55). A total of 28 cases (16.9%) showed complications, most of which were transient pain after embolization. No serious complications such as coil embolization to the lungs occurred. In addition, the CPG group used fewer coils than the CPS group by using the Slope Embankment Technique(SET) . The mean coil length of the CPG group was 77.18±33.82 cm, and the CPS group was 105.29±71 cm(P=0.001). The CPG group had an average operation time of 44.49±5.72 min, while the CPS group took 43.45±4.18 min on average(P=0.19). The radiation dose of the CPG group was 398.40±76.16mGy, and the radiation dose of the CPS group was 388±44.23mGy(P=0.30). The median recurrence free survival(RFS) of the CPG group was 34.23 months (95% CI 33.2-35.2), and the median RFS of the CPS group was 30.39 months (95% CI 28.2-32.6), LogRank=0.018. ConclusionsEmbolization therapy for refluxing PeVD was safe and effective, and proficient use of SET with coils plus glue increased efficacy and reduced complications.