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Uterine artery embolization

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https://www.readbyqxmd.com/read/29147816/development-of-pseudoaneurysm-in-cesarean-section-scar-pregnancy-a-case-report-and-literature-review
#1
Shunki Kiyokawa, Tatsuyuki Chiyoda, Kazunori Ueno, Keiko Saotome, Seon-Hye Kim, Sakura Nakada
Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy. It is becoming more common, but it can lead to uterine rupture and severe hemorrhage. Here, we report a case of a 37-year-old woman with CSP complicated with pseudoaneurysm. The pseudoaneurysm emerged following focal injection of methotrexate (MTX) and potassium chloride with systemic MTX treatment. Due to a risk of sudden bleeding, uterine artery embolization (UAE) was recommended, but the patient hoped to avoid this if possible. Because the serum human chorionic gonadotropin level and the gestational sac were still persistent, dilation and curettage were performed with interventional radiologists on standby...
November 16, 2017: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/29128204/uterine-artery-embolization-a-review-of-current-concepts
#2
REVIEW
Jonathan J Keung, James B Spies, Theresa M Caridi
Uterine artery embolization (UAE) has gained traction as a safe and effective treatment modality for symptomatic uterine leiomyomata since its introduction nearly two decades ago. This review includes an overview of current concepts with regard to patient selection, technique, and outcomes following UAE. Specific topics also include the impact of this procedure on fertility and pregnancy, the emerging role of UAE in the treatment of adenomyosis, and how UAE compares with surgical intervention for the treatment of symptomatic leiomyomata...
September 29, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29124818/diagnosis-and-management-of-patients-with-enhanced-myometrial-vascularity-associated-with-retained-products-of-conception
#3
Yvette S Groszmann, Amie Lynn Healy Murphy, Beryl R Benacerraf
OBJECTIVES: We performed this study to assess the complication rate, including the estimated amount of blood loss, in patients who underwent dilation and curettage for treatment of retained products of conception with markedly enhanced myometrial vascularity mimicking arteriovenous malformations. METHODS: This is a retrospective medical records review study of patients with retained products of conception with enhanced myometrial vascularity presenting to our ultrasound unit between August 1, 2015 and August 1, 2017...
November 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29107951/the-effect-of-tranexamic-acid-on-blood-loss-and-maternal-outcome-in-the-treatment-of-persistent-postpartum-hemorrhage-a-nationwide-retrospective-cohort-study
#4
Ada Gillissen, Dacia D C A Henriquez, Thomas van den Akker, Camila Caram-Deelder, Merlijn Wind, Joost J Zwart, Jos van Roosmalen, Jeroen Eikenboom, Kitty W M Bloemenkamp, Johanna G van der Bom
BACKGROUND: Recent results show a protective effect of tranexamic acid on death due to bleeding in patients with postpartum hemorrhage in low- and middle-resource countries. We quantify the association between early administration of tranexamic acid compared to late or no administration and severe acute maternal morbidity and blood loss among women suffering from persistent severe postpartum hemorrhage in a high-income country. METHODS AND FINDINGS: We performed a nationwide retrospective cohort study in 61 hospitals in the Netherlands...
2017: PloS One
https://www.readbyqxmd.com/read/29099026/cost-and-distribution-of-hysterectomy-and-uterine-artery-embolization-in-the-united-states-regional-rural-urban-disparities
#5
Marquisette Glass Lewis, Olúgbémiga T Ekúndayò
Hysterectomy, the driving force for symptomatic uterine fibroids since 1895, has decreased over the years, but it is still the number one choice for many women. Since 1995, uterine artery embolization (UAE) has been proven by many researchers to be an effective treatment for uterine fibroids while allowing women to keep their uteri. The preponderance of data collection and research has focused on care quality in terms of efficiency and effectiveness, with little on location and viability related to care utilization, accessibility and physical availability...
May 16, 2017: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29090998/pelvic-blood-flow-predicts-fibroid-volume-and-embolic-required-for-uterine-fibroid-embolization-a-pilot-study-with-4d-flow-mr-angiography
#6
Christopher D Malone, Arjun Banerjee, Marcus T Alley, Shreyas S Vasanawala, Anne C Roberts, Albert Hsiao
OBJECTIVE: We report here an initial experience using 4D flow MRI in pelvic imaging-specifically, in imaging uterine fibroids. We hypothesized that blood flow might correlate with fibroid volume and that quantifying blood flow might help to predict the amount of embolic required to achieve stasis at subsequent uterine fibroid embolization (UFE). MATERIALS AND METHODS: Thirty-three patients with uterine fibroids and seven control subjects underwent pelvic MRI with 4D flow imaging...
November 1, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29090348/characteristics-of-a-new-x-ray-imaging-system-for-interventional-procedures-improved-image-quality-and-reduced-radiation-dose
#7
Ruediger E Schernthaner, Reham R Haroun, Sonny Nguyen, Rafael Duran, Jae Ho Sohn, Sonia Sahu, Julius Chapiro, Yan Zhao, Alessandro Radaelli, Imramsjah M van der Bom, Maria Mauti, Kelvin Hong, Jean-François H Geschwind, MingDe Lin
PURPOSE: To compare image quality and radiation exposure between a new angiographic imaging system and the preceding generation system during uterine artery embolization (UAE). MATERIALS AND METHODS: In this retrospective, IRB-approved two-arm study, 54 patients with symptomatic uterine fibroids were treated with UAE on two different angiographic imaging systems. The new system includes optimized acquisition parameters and real-time image processing algorithms. Air kerma (AK), dose area product (DAP) and acquisition time for digital fluoroscopy (DF) and digital subtraction angiography (DSA) were recorded...
October 31, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29067758/scoring-model-to-predict-massive-post-partum-bleeding-in-pregnancies-with-placenta-previa-a-retrospective-cohort-study
#8
Ji Yeon Lee, Eun Hee Ahn, Sukho Kang, Myung Jin Moon, Sang Hee Jung, Sung Woon Chang, Hee Young Cho
AIM: We aimed to identify factors associated with massive post-partum bleeding in pregnancies with placenta previa and to establish a scoring model to predict post-partum severe bleeding. METHODS: A retrospective cohort study was performed in 506 healthy singleton pregnancies with placenta previa from 2006 to 2016. Cases with intraoperative blood loss (≥2000 mL), packed red blood cells transfusion (≥4), uterine artery embolization, or hysterectomy were defined as massive bleeding...
October 25, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29065701/postpartum-hemorrhage-from-non-uterine-arteries-clinical-importance-of-their-detection-and-the-results-of-selective-embolization
#9
Jeong-Eun Kim, Young Ho So, Byoung Jae Kim, Sun Min Kim, Young Ho Choi, Chang Kyu Sung
Background Identification of the source of postpartum hemorrhage (PPH) is important for embolization because PPH frequently originates from non-uterine arteries. Purpose To evaluate the clinical importance of identifying the non-uterine arteries causing the PPH and the results of their selective embolization. Material and Methods This retrospective study enrolled 59 patients who underwent embolization for PPH from June 2009 to July 2016. Angiographic findings and medical records were reviewed to determine whether non-uterine arteries contributed to PPH...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/29060964/-clinical-analysis-on-hysteroscopic-surgery-for-the-treatment-of-type-%C3%A2-cesarean-scar-pregnancy-in-the-first-trimester
#10
COMPARATIVE STUDY
Z Y Chen, X Y Li, D Zhao, M Zhou, P Xu, X F Huang, X M Zhang
Objective: To investigate the safety and efficacy of hysterosopic management of type Ⅱ cesarean scar pregnancy (CSP) and the value of prophylactic uterine artery embolization (UAE). Methods: Totally 104 patients with type Ⅱ CSP treated with hysteroscopic surgery at the Women's Hospital, School of Medicine, Zhejiang University, during Jan. 2009 to Jun. 2016 were analyzed retrospectively, 67 patients combined with UAE (UAE group) and 37 patients without combined with UAE (non-UAE group). Laparoscopy or sonography guidance was conducted simultaneously...
October 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29056469/intrauterine-bakri-balloon-and-vaginal-tamponade-combined-with-abdominal-compression-for-the-management-of-postpartum-hemorrhage
#11
Yuna Guo, Renyi Hua, Shoufang Bian, Xianjing Xie, Jue Ma, Yanqin Cai, Suren R Sooranna, Weiwei Cheng
OBJECTIVE: This study sought to investigate the effect of Bakri balloon use and vaginal tamponade combined with abdominal compression for the management of postpartum hemorrhage (PPH). METHODS: This retrospective study reviewed cases of PPH in the International Peace Maternal and Child Health Hospital of China Welfare Institution in Shanghai, China from January 1, 2010 to December 31, 2015. A single use of the intrauterine Bakri balloon was applied in some cases, and additional vaginal tamponade combined with abdominal compression (double compression) was applied in other cases...
October 19, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29052017/fertility-after-uterine-artery-embolization-of-fibroids-a-systematic-review
#12
REVIEW
K Karlsen, A Hrobjartsson, M Korsholm, O Mogensen, P Humaidan, P Ravn
PURPOSE: The impact of uterine artery embolization (UAE) for the purpose of diminishing the effect of uterine fibroids on fertility is unclear. We have investigated the reported rates of pregnancy and miscarriage after treatment of uterine fibroids with UAE. MATERIALS AND METHODS: We searched for relevant information in PubMed and Embase for randomized controlled trials (RCT), controlled clinical trials, comparative before-after trials, cohort studies, case-control studies and case series where UAE treatment of premenopausal women was performed for uterine fibroids with and where a control intervention was included...
October 20, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29034092/choosing-the-uterine-preservation-surgery-for-placental-polyp-determined-by-blood-flow-evaluation-a-retrospective-cohort-study
#13
Sumire Sorano, Tatsuya Fukami, Maki Goto, Sakiko Imaoka, Miho Ando, Yoko To, Sumie Nakamura, Hiroko Yamamoto, Fuyuki Eguchi, Hiroshi Tsujioka
BACKGROUND: A placental polyp is an intrauterine polypoid mass or pedunculated mass occurring from residual trophoblastic tissue following abortion, cesarean section or vaginal delivery. Recently uterine preservation surgery represented by transcervical resection (TCR) has been performed for placental polyps. However TCR without intravascular intervention, including uterine artery embolization (UAE) may cause profound bleeding which necessitate emergency laparotomy. METHODS: Seventeen cases of placental polyp were retrospectively examined...
November 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29032946/uterine-artery-embolization-for-the-treatment-of-adenomyosis-a-systematic-review-and-meta-analysis
#14
REVIEW
Annefleur M de Bruijn, Marieke Smink, Paul N M Lohle, Judith A F Huirne, Jos W R Twisk, Caroline Wong, Linda Schoonmade, Wouter J K Hehenkamp
The effect of uterine artery embolization (UAE) on symptomatic adenomyosis was evaluated in a systematic review and meta-analysis. Four groups were evaluated: short-term (< 12 months) pure adenomyosis, short-term adenomyosis with fibroids (combined adenomyosis), long-term (> 12 months) pure adenomyosis, and long-term combined adenomyosis. Improvement of symptoms occurred in 83.1% (872/1,049) of patients. Reported symptom reduction was 4.8% greater in the short-term combined group (P = .169) and 11.4% greater in the long-term combined group (P = ...
October 9, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29016510/comparative-effectiveness-of-uterine-leiomyoma-procedures-using-a-large-insurance-claims-database
#15
COMPARATIVE STUDY
Bijan J Borah, Xiaoxi Yao, Shannon K Laughlin-Tommaso, Herbert C Heien, Elizabeth A Stewart
OBJECTIVE: To compare risk of reintervention, long-term clinical outcomes, and health care utilization among women who have bulk symptoms from leiomyoma and who underwent the following procedures: hysterectomy, myomectomy, uterine artery embolization, and magnetic resonance-guided, focused ultrasound surgery. METHODS: This was a retrospective analysis of administrative claims from a large U.S. commercial insurance database. Women aged 18-54 years undergoing any of the previously mentioned leiomyoma procedures between 2000 and 2013 were included...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28992892/obstetric-risk-factors-for-depression-during-the-postpartum-period-in-south-korea-a-nationwide-study
#16
HyunChul Youn, Suji Lee, Sung Won Han, Log Young Kim, Tae-Seon Lee, Min-Jeong Oh, Hyun-Ghang Jeong, Geum Joon Cho
OBJECTIVE: Postpartum depression is related to many adverse effects in both mothers and their children; therefore, proper screening and early interventions are needed. This study aims to identify the risk factors of postpartum depression. Our primary focus is on obstetric risk factors. METHODS: This study is a cross-sectional study which we extracted the data of women who gave birth between January 1st, 2010 and December 31st, 2012 from the Health Insurance Review and Assessment service (HIRA) database...
November 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28980065/conservative-endovascular-management-of-retained-placenta-accreta-with-marked-vascularity-after-abortion-or-delivery
#17
Akihiro Takeda, Wataru Koike
OBJECTIVE: To report our experience on the value of transcatheter arterial embolization (TAE) or transcatheter arterial chemoembolization (TACE) for the uterus-preserving management of retained placenta accreta with marked vascularity after abortion or delivery. STUDY DESIGN: Thirty-eight consecutive women with retained placenta accreta were retrospectively analyzed over a 5-year period. When elevated levels of serum β-hCG (> 25 mIU/mL) were detected, TACE with dactinomycin was chosen for devascularization along with cytotoxic effects on active trophoblasts; in contrast, if the serum β-hCG level was low (≤ 25 mIU/mL), TAE was chosen...
December 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28965438/postpartum-hemorrhage-with-pelvic-arterial-embolization-study-of-33-cases
#18
Alejandra Aguilar-Crespo, José Morales-Roselló, Carlos Sánchez-Ajenjo, Ana Valle-Tejero, Raúl García-Marcos, Alfredo Perales-Marín
OBJECTIVE: To describe our cases of postpartum hemorrhage (PPH) with pelvic arterial embolization (PAE). MATERIAL AND METHODS: All patients with PPH who underwent PAE in our center in the interval 2011-1016 were retrospectively studied, evaluating the technical procedure, clinical results, and subsequent fertility. RESULTS: There were 33 cases of PPH with PAE. The majority occurred in primiparous women (N = 22, 66.6%) who delivered vaginally (N = 20, 61%)...
October 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28959456/embolization-of-a-life-threatening-placenta-increta-hemorrhage-with-a-four-month-mri-follow-up
#19
Annika Bach, Anne Bartens, Gabriele Gossing, Bernhard Gebauer, Rolf W Günther, Christian Althoff
A 29-year-old woman with partial placenta increta was treated by bilateral uterine artery embolization (UAE) for bleeding with hemorrhagic shock two months after delivery, resulting in permanent hemostasis. The patient underwent a total of three magnetic resonance imaging (MRI) examinations-before UAE and four days and four months after UAE. At four months, MRI showed a fully regenerated uterus with preserved perfusion and complete resolution of residual placental tissue.
September 2017: Acta Radiologica Open
https://www.readbyqxmd.com/read/28951653/symptomatic-fibroid-management-systematic-review-of-the-literature
#20
REVIEW
Yelena Havryliuk, Robert Setton, John J Carlow, Barry D Shaktman
BACKGROUND AND OBJECTIVES: Symptomatic uterine fibroids are a societal and healthcare burden with no clear consensus among medical professionals as to which procedural treatment is most appropriate for each symptomatic patient. Our purpose was to determine whether recommendations can be made regarding best practice based on review and analysis of the literature since 2006. DATABASE: A systematic search of journal articles relevant to the treatment of symptomatic uterine fibroids was performed within PubMed, clinical society websites, and medical device manufacturers' websites...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
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