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Pelvic embolization

Heather Miller, Matthew L Anderson, Christopher P Smith, Alireza A Shamshirsaz, Karin A Fox
BACKGROUND: Chylous ascites is defined as the pathologic accumulation of lymphatic fluid within the peritoneal cavity and has been reported to complicate gynecologic surgeries, with an incidence of 0.17-2%. We report a case of chylous ascites after complex surgery for placenta percreta. CASE: A 26-year-old woman underwent cesarean delivery followed by bilateral uterine artery embolization and modified radical hysterectomy at 26 5/7 weeks of gestation for placenta percreta invading the urinary bladder...
October 6, 2016: Obstetrics and Gynecology
A Kent, F Shakir, T Rockall
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Cahit Sahin, Utku Can, Bilal Eryildirim, Kemal Sarica
To evaluate the short term effects of transient AP medication cessation on the safety of percutaneous nephrolithotomy (PCNL) and evaluate them with normal cases in a comparative manner. 71 cases undergoing PCNL for renal pelvic stones were divided into two groups: Group 1 (n: 35) Cases under AP medication (100 mg/day acetyl salicylic acid) in whom the medication was stopped for 7 days before PCNL procedure. Group 2 (n: 36) Cases without any AP medication prior to PCNL. Coagulation test parameters were normal in all cases prior to stone removal...
September 27, 2016: Urolithiasis
Maitri Raghavendra Kulkarni, Indranil Dutta, Dilip Kumar Dutta
BACKGROUND AND OBJECTIVES: Leiomyoma of uterus forms the most common type of benign tumor of uterus and also the most common pelvic tumor in women. The symptomatology continues to be variable. Surgery has for long been the main mode of therapy for the myomas. For women who wish to retain the uterus for future pregnancies or other reasons, myomectomy is preferred. Recent trend has been toward nonsurgical approaches like GnRH hormone analogs/agonists, RU 486, or selective uterine artery embolization, laparoscopic cryoablation, radiofrequency thermal ablation, and MRGUs...
October 2016: Journal of Obstetrics and Gynaecology of India
Nuri Peker, Savas Gundogan, Fatih Sendag
To present the feasibility of laparoscopic management of huge myoma nascendi DESIGN: Step by step explanation of the surgery using video SETTING: Uterine fibroids are the most common benign neoplasm of the female reproductive tract with the estimated incidence of 25-30% at reproductive age. Patients generally have no symptoms however patients those have symptoms such as severe pelvic pain, heavy uterine bleeding or infertility may undergo surgery. The traditional management is surgery however uterine artery embolization, hormonal therapy using GnRH (Gonadotropin-Releasing Hormone) agonists or SERM (Selective Estrogen Receptor Modulator) should be preferred as the medical approach...
September 12, 2016: Journal of Minimally Invasive Gynecology
Nuri Peker, Savaş Gundogan, Fatih Şendağ
To present the feasibility of laparoscopic management of huge cervical myoma DESIGN: Step by step explanation of the surgery using video SETTING: Uterine fibroids are the most common benign neoplasm of the female reproductive tract with the estimated incidence of 25-30% at reproductive age. Patients generally have no symptoms however patients those have symptoms such as severe pelvic pain, heavy uterine bleeding or infertility may undergo surgery. The traditional management is surgery however uterine artery embolization, hormonal therapy using GnRH (Gonadotropin-Releasing Hormone) agonists or SERM (Selective Estrogen Receptor Modulator) should be preferred as the medical approach...
September 12, 2016: Journal of Minimally Invasive Gynecology
Alessio Comai, Marianna Zatelli, Thomas Haglmuller, Giampietro Bonatti
PURPOSE: The most common life-threatening complication of pelvic trauma is bleeding. Arterial bleedings frequently require active management, preferably with transcatheter arterial embolization (TAE). Hemodynamic instability and/or contrast extravasation at computer tomography (CT) examination are reliable indicators of arterial injury. Unstable pelvic fractures are much more hemorrhagic than stable fractures. Nevertheless, an absent or isolated pelvic fracture does not exclude pelvic hemorrhage...
2016: Curēus
RoseMarie Kearsley, John Galbraith, David Dalton, Catherine Motherway
Fat embolism syndrome (FES) is a rare and potentially fatal complication occurring most often after long bone or pelvic fractures and orthopaedic procedures. It can consist of pulmonary, central nervous system and cutaneous manifestations. The exact pathophysiology of emboli reaching the arterial circulation is poorly understood.1 It is suggested that this may occur by either 'paradoxical' embolism or microembolism.2 3 Its true incidence is unknown but increases in the presence of multiple closed fractures...
2016: BMJ Case Reports
Alexandre Escande, Renaud Mazeron, Sebastien Gouy, Enrica Bentivegna, Pierre Maroun, Georges Fahra, Anne-Sophie Oberlander, Isabelle Dumas, Pauline Castelnau-Marchand, Eric Deutsch, Philippe Morice, Christine Haie-Meder, Cyrus Chargari
OBJECTIVE: To examine the clinical results of a preoperative image-guided pulse-dose-rate brachytherapy (PDR-BT) in early stage cervical cancer. MATERIALS/METHODS: We examined the outcome of consecutive patients with early stage cervical cancer undergoing preoperative image-guided PDR-BT between 2004 and 2013 because of risk factors (lymphovascular embols and/or tumour>2cm). The objective was to deliver 60Gy to 100% of the intermediate risk clinical target volume...
September 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
F J Ruiz Labarta, M P Pintado Recarte, A Alvarez Luque, L Joigneau Prieto, L Perez Martín, M Gonzalez Leyte, F Palacio Abizanda, F Morillas Ramirez, A Perez Corral, L Ortiz Quintana, J De Leon-Luis
BACKGROUND: Postpartum haemorrhage (PPH) is an unpredictable obstetric emergency that requires a multidisciplinary approach. Pelvic arterial embolization (PAE) is considered as a second-line treatment, although the published results have not been reviewed systematically since 2007. OBJECTIVES: To evaluate success and complication rates of PAE to treat PPH in the study hospital between 2009 and 2015, and to perform a systematic review of the literature on the reported efficacy and safety of PAE for the management of PPH...
August 4, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Ronald Tesoriero, Brandon Bruns, Mayur Narayan, Joseph Dubose, Sundeep Guliani, Megan Brenner, Sharon Boswell, Deborah M Stein, Thomas Scalea
INTRODUCTION: Major pelvic disruption with hemorrhage has a high rate of lethality. Angiographic embolization remains the mainstay of treatment. Delays to angiography have been shown to worsen outcomes, in part because time spent awaiting mobilization of resources needed to perform angiography allows ongoing hemorrhage. Alternative techniques like pelvic pre-peritoneal packing (PPP) and aortic balloon occlusion (REBOA) now exist. We hypothesized that time to angiographic embolization at our level 1 trauma center would be longer than 90 minutes...
September 16, 2016: Journal of Trauma and Acute Care Surgery
Sangeeta Ramanan, Jude Chapman-Wardy, Roy Watson
A 43-year-old woman presented with severe anaemia secondary to menorrhagia. Pelvic ultrasound showed a large intramural posterior fundal fibroid. Hysteroscopy showed the fibroid distorting the endometrial cavity, precluding Mirena® device insertion. As she was initially hesitant to have a hysterectomy, medical management with the oral contraceptive pill (OCP) and tranexamic acid was instituted, with good effect. Months later, after a long road trip, she presented with left leg swelling, and a Doppler ultrasound confirmed an extensive deep vein thrombosis (DVT)...
2016: Case Reports in Obstetrics and Gynecology
Pietro Giovanni di Summa, Clara Schaffer, Patrice Zaugg, Olivier Bauquis, Wassim Raffoul
We report the case of a 52-year-old man presenting an extensive lumbosacral necrosis after bilateral internal iliac arteries embolization following unstable pelvic fracture. Coverage of the defect was performed using two extended lumbar artery perforator flaps in a propeller fashion. Good functional and esthetic result was achieved at one-year follow-up.
2016: Case Reports in Plastic Surgery & Hand Surgery
Ari J Isaacson, Lauren M B Burke
Pelvic computed tomography angiography (CTA) prior to prostatic artery embolization is a beneficial tool for preprocedural planning to increase the likelihood of success during what can be a challenging procedure. Additionally, the same CTA images can be used for calculating the baseline prostate volume as well as for intraprocedural anatomic guidance, adding to the value of the scan. This article discusses the technique used for pelvic CTA and its role in preprocedural assessment of the pelvic vasculature prior to prostatic artery embolization...
September 2016: Seminars in Interventional Radiology
Aska Toda, Kenjiro Sawada, Keigo Osuga, Noboru Maeda, Hiroki Higashihara, Tomoyuki Sasano, Noriyuki Tomiyama, Tadashi Kimura
AIM: The aim of this study was to retrospectively analyze the efficacies of uterine artery embolization (UAE) using gelatin sponge for symptomatic uterine fibroids. METHODS: A series of 60 consecutive premenopausal women underwent UAE using gelatin sponge particles or porous gelatin particles. Patients were routinely followed up at 1, 3, 6, and 12 months after the procedure and asked to report any procedure-related complications. At each follow-up, an original clinical questionnaire was completed by the patients to evaluate changes in fibroid-related symptoms...
2016: International Journal of Women's Health
Rui Manuel Machado, Duarte Nuno Cunha Rego, Pedro Nuno Ferreira Pinto de Oliveira, Rui Manuel Gonçalves Fernandes de Almeida
OBJECTIVE: Internal iliac artery aneurysms (IIAA) are rare, representing only 0.3% of aortoiliac aneurysms. Its treatment with open surgery is complex and associated with high morbidity and mortality, which led to increasing application of endovascular solutions. In this study, we aimed to evaluate outcomes of endovascular aneurysm repair (EVAR) of IIAA in one institution. METHODS: We retrospectively reviewed all cases of IIAA treated with endovascular techniques between 2003 and 2014...
April 2016: Brazilian Journal of Cardiovascular Surgery
Christian David Weber, Christian Herren, Thomas Dienstknecht, Frank Hildebrand, Sebastian Keil, Hans-Christoph Pape, Philipp Kobbe
BACKGROUND: Life-threatening arterial bleeding from fragility fractures of the pelvis are very rare but associated with significant mortality, especially in anticoagulated patients. CASE DESCRIPTION: We report the successful interdisciplinary management of a 78-year-old woman under anticoagulation and antiplatelet therapy who had life-threatening arterial hemorrhage from the pubic rami following a fragility fracture of the pelvis. Our management strategy included early hemorrhage control by means of selective arterial embolization followed by surgical fracture stabilization and surgical hematoma evacuation...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
James Shi, Antoinette Gomes, Edward Lee, Stephen Kee, John Moriarty, Henry Cryer, Justin McWilliams
PURPOSE: Transcatheter arterial embolization (TAE) is commonly used to control hemorrhage after pelvic trauma. Despite the procedures reported safety, there can be severe complications, mostly related to ischemia of embolized tissues. Our purpose was to examine the complications of trauma patients resulting from the embolization techniques utilized at our level 1 trauma center. MATERIALS AND METHODS: A retrospective chart review was conducted. One hundred and seven patients who underwent pelvic embolization between January 2003 and December 2013 were included...
August 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Amita Jain, Virender Singh Sheorain, Kulbeer Ahlawat, Rajesh Ahlawat
AIM OF THE VIDEO: Sacrospinous ligament fixation (SSLF) is a minimally invasive transvaginal procedure for correcting apical prolapse. Amongst perioperative complications, life-threatening hemorrhage has a reported occurrence rate ranging from 0.2 % to 2 %. We present a case of arterial hemorrhage following SSLF and a multispecialty approach to its successful management. METHODS: The video demonstrates the development of an unexpected progressive postoperative hematoma following left-side sacrospinous hysterocolpopexy via the anterior approach, despite minimal intraoperative bleeding...
August 18, 2016: International Urogynecology Journal
Lonnie Froberg, Frederik Helgstrand, Caroline Clausen, Jacob Steinmetz, Henrik Eckardt
OBJECTIVE: Exsanguination due to coagulopathy and vascular injury is a common cause of death among trauma patients. Arterial injury can be treated either by angiography and embolization or by explorative laparotomy and surgical packing. The purpose of this study was to compare 30-day mortality and blood product consumption in trauma patients with active arterial haemorrhage in the abdominal and/or pelvic region treated with either angiography and embolization or explorative laparotomy and surgical packing...
July 2016: Journal of Emergencies, Trauma, and Shock
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