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uterine arteriovenous fistula

Andrew Marshall, Montu Patel, Navid Eghbalieh, Mandy Weidenhaft, Cynthia Hanemann, Harold Neitzschman
Arteriovenous malformations (AVMs) are a rare source of potentially life-threatening uterine bleeding, and should be suspected in patients presenting with metromenorrhagia. Histologically, AVMs are characterized as having both arterial and venous tissues without an intervening capillary network.1 The etiology may be either congenital or acquired secondary to prior uterine surgery or uterine malignancy.2 Congenital lesions are thought to result from arrested vascular development and contain a nidus of multiple feeding arteries anastomosed to multiple draining veins...
July 2015: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Andrew Marshall Md, Montu Patel Md, Navid Eghbalieh Md, Mandy Weidenhaft Md, Cynthia Hanemann Md, Harold Neitzschman Md
Arteriovenous malformations (AVMs) are a rare source of potentially life-threatening uterine bleeding, and should be suspected in patients presenting with metromenorrhagia. Histologically, AVMs are characterized as having both arterial and venous tissues without an intervening capillary network.1 The etiology may be either congenital or acquired secondary to prior uterine surgery or uterine malignancy.2 Congenital lesions are thought to result from arrested vascular development and contain a nidus of multiple feeding arteries anastomosed to multiple draining veins...
July 2015: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
José-Fernando Val-Bernal, Sandra Hermana
A uterine arteriovenous malformation (AVM) is an uncommon cause of uterine bleeding. Location of this lesion in the uterine cervix is exceptional. We report a case of a 34-year-old woman who presented with chronic menorrhagias and hypochromic anemia. A sonographic study revealed a 10-cm, fundal, intramural, uterine well-circumscribed mass that distorted the endometrial cavity. The patient underwent hysterectomy for a large uterine leiomyoma. The pathological study revealed an incidental AVM of the posterior half of the cervix measuring 5...
March 2016: Pathology, Research and Practice
Vinicius Adami Vayego Fornazari, Denis Szejnfeld, Julio Elito Júnior, Suzan Menasce Goldman
The advent of interventional radiology enabled remarkable advances in diagnosis and treatment of several situations in obstetrics and gynecology. In the field of obstetrics, these advances include temporary occlusion of the iliac arteries to the management of placenta accreta and/or prior, arteriovenous fistulas after embolization of uterine curettage and management of ectopic uterine and extra-uterine pregnancies. The non-tubal ectopic pregnancy, either cervical, abdominal, ovarian or in a cesarean scar, often represents major therapeutic challenge, especially when exists a desire to maintain fertility...
January 2015: Einstein
Philippe Soyer, Anthony Dohan, Raphael Dautry, Youcef Guerrache, Aude Ricbourg, Etienne Gayat, Mourad Boudiaf, Marc Sirol, Olivier Ledref
Postpartum hemorrhage (PPH) is a potentially life-threatening condition, which needs multidisciplinary management. Uterine atony represents up to 80 % of all causes of PPH. Transcatheter arterial embolization (TAE) has now a well-established role in the management of severe PPH. TAE allows stopping the bleeding in 90 % of women with severe PHH, obviating surgery. Pledgets of gelatin sponge as torpedoes are commonly used for safe TAE, and coils, glue, and microspheres have been primarily used in specific situations such as arterial rupture, pseudoaneurysm, and arteriovenous fistula...
October 2015: Cardiovascular and Interventional Radiology
Shakeel Ahmed, Syed Rehan Ali, Naila Nadeem, Muhammad Hamid
Vascular Ehlers-Danlos Syndrome (VEDS), previously called Ehlers-Danlos syndrome type-IV, is a heterogeneous group of heritable connective tissue disorders characterized by thin, translucent skin, easy bruising, arterial, intestinal, and/or uterine fragility. There is large vessel involvement that leads to arterial rupture often preceded by aneurysm, arteriovenous fistulae, or dissection. Noninvasive imaging studies such as CT angiography and MR angiography are preferred as diagnostic studies for this condition...
November 2014: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
C Y Akladios, N Sananes, A Gaudineau, E Boudier, B Langer
OBJECTIVES: To define secondary postpartum hemorrhage (HSPP), to discuss its main etiologies and suggest a proposal for its management. MATERIALS AND METHODS: Bibliographic research by crossing keywords: secondary postpartum hemorrhage, delayed postpartum hemorrhage, postpartum bleeding, placental remnant, placental and hysteroscopy. RESULTS: The HSPP (0.5 and 2%) is defined as bleeding occurring between 24hours and 6weeks after birth and requiring therapeutic action whatsoever (professional consensus)...
December 2014: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Reiko Woodhams, Go Ogasawara, Kenichiro Ishida, Kaoru Fujii, Takuro Yamane, Hiroshi Nishimaki, Keiji Matsunaga, Yusuke Inoue
We present two cases of acquired uterine arterial venous malformation (AVM) which was diagnosed because of massive genital bleeding successfully treated with transcatheter arterial embolization (TAE), using N-butyl-2-cyanoacrylate (NBCA) under balloon occlusion. Balloon occlusion at the uterine artery was performed in both patients for diffuse distribution of NBCA in multiple feeding branches, as well as to the pseudoaneurysm, and for the prevention of NBCA reflux. In one of our patients, balloon occlusion of the draining vein was simultaneously performed to prevent NBCA migration through accompanying high-flow arteriovenous fistula (AVF)...
September 2014: Acta Radiologica Short Reports
Naoko Yamamoto, Kaori Koga, Masaaki Akahane, Osamu Wada-Hiraike, Tomoyuki Fujii, Yutaka Osuga
Arteriovenous fistula is any abnormal connection between an artery and a vein that bypasses the normal capillary bed and shunts arterial blood directly to the venous circulation. Uterine arteriovenous fistula (UAVF) is a potentially life-threatening condition by causing massive bleeding. This report describes a case of UAVF with massive hemorrhage. Prior to surgery, endovascular catheters for balloon occlusion were placed within bilateral uterine arteries. During surgery, the surgeon requested temporary balloon inflation for navigating and identifying inflow arteries...
February 2015: Journal of Obstetrics and Gynaecology Research
Akihiro Takeda, Wataru Koike, Sanae Imoto, Hiromi Nakamura
OBJECTIVE: To report our experience on the value of dynamic three-dimensional computerized tomographic (CT) angiography for immediate diagnosis and management of intractable postpartum hemorrhage (PPH). STUDY DESIGN: Retrospective study of all cases of PPH examined by three-dimensional CT angiography between January 2007 and August 2013 in a single center. In each case, emergency dynamic CT was taken at the early arterial, late arterial and venous phases to identify the extravasated contrast agent that represents active hemorrhage...
May 2014: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Nidhi Sharma, Deepa Ganesh, Lakshmi Devi, Jayashree Srinivasan, Upasana Ranga
Post-partum haemorrhage is a major determinant of maternal mortality. Traditionally, cases of post-partum haemorrhage caused by arterial injuries were managed by caesarean hysterectomies or bilateral internal iliac artery ligations. The diagnosis of aneurysms or arteriovenous malformations of uterine artery are often missed. Uterine curettage, caesarean section or vaginal delivery can result in uterine vascular anomalies like pseudo aneurysms, arteriovenous malformations, arteriovenous fistula and rupture of uterine vessels...
October 2013: Journal of Clinical and Diagnostic Research: JCDR
Janelle K Moulder, Leslie A Garrett, Gloria M Salazar, Annekathryn Goodman
BACKGROUND: Acquired arteriovenous malformations (AVMs) can develop after uterine instrumentation. The increased risks of vascular changes, including abnormal placentation, after repeated cesarean sections are well studied. Herein, we describe a patient with delayed hemorrhage from a uterine AVM, following dilation and curettage for a cesarean scar pregnancy. CASE: A 32-year-old G3P2 presented with a cesarean scar ectopic pregnancy managed with dilation and curettage, which incurred a 1,500-ml blood loss...
May 2013: Case Reports in Oncology
Barton F Lane, Jade J Wong-You-Cheong, Marcia C Javitt, Phyllis Glanc, Douglas L Brown, Theodore Dubinsky, Mukesh G Harisinghani, Robert D Harris, Nadia J Khati, Donald G Mitchell, Pari V Pandharipande, Harpreet K Pannu, Anne E Podrasky, Thomas D Shipp, Cary Lynn Siegel, Lynn Simpson, Darci J Wall, Carolyn M Zelop
Vaginal bleeding is not uncommon in the first trimester of pregnancy. Ultrasound is the foremost modality for evaluating normal development of the gestational sac and embryo and for discriminating the causes of bleeding. While correlation with quantitative βHCG and clinical presentation is essential, sonographic criteria permit diagnosis of failed pregnancies, ectopic pregnancy, gestational trophoblastic disease and spontaneous abortion. The American College of Radiology Appropriateness Criteria guidelines have been updated to incorporate recent data...
June 2013: Ultrasound Quarterly
Y Levy-Zaubermann, Perrine Capmas, G Legendre, H Fernandez
Uterine arteriovenous malformation (AVM) can be congenital or acquired. When acquired (e.g., fistula), it results from abnormal arteriovenous communication between one or more uterine arteries and a myometrial and/or endometrial venous plexus, without the interposition of a vascular nidus. Arteriovenous malformation is composed of a tortuous net of fragile low-resistant arteriovenous shunts. Other arteries can be involved in fistulas, including ovarian arteries or those from the round ligaments of the uterus, in particular in congenital AVMs, which develop from failure in embryologic differentiation that leads to multiple abnormal vascular connections...
November 2012: Journal of Minimally Invasive Gynecology
Akiko Hasegawa, Hiroki Sasaki, Osamu Wada-Hiraike, Yutaka Osuga, Tetsu Yano, Salmyah M Usman, Masaaki Akahane, Shiro Kozuma, Yuji Taketani
Uterine arteriovenous fistula (AVF) is a rare entity, but may lead to life-threatening hemorrhage. Although transcatheter embolization, surgical ligation, or hysterectomy would be considered for treatment of uterine AVF, there is poor knowledge as to how gynecologists can manage the uterine AVF with multiple large inflow arteries. Herein we report a uterine AVF successfully treated using multiple-step transcatheter embolization. The patient, a 58-year-old postmenopausal woman with a history of dilation and curettage, had intermittent massive uterine bleeding...
November 2012: Journal of Minimally Invasive Gynecology
R E Brightwell, P J Walker
Ehlers-Danlos syndrome type IV (EDS type IV), the vascular type, results from mutations in the gene for type III procollagen (COL3A1). Affected patients are at risk for arterial, bowel, and uterine rupture. The timing, frequency and course of these events are unpredictable. We report a 50-year-old patient with previous complications of EDS type IV who presented with recurrent varicose veins that subsequent imaging identified as an arteriovenous fistula (AVF) at the site of previous phlebectomy. Patients with EDS type IV present vascular surgeons manifold management problems...
November 2011: European Journal of Vascular and Endovascular Surgery
R Kizaki, J Fujimoto, E Sato, T Tamaya
BACKGROUND: The major presenting symptom of uterine arteriovenous fistulas is massive, torrential vaginal bleeding, the degree of which often leads to a shock state. CASE: A 35-year-old woman, gravida 3, para 2 presented with massive vaginal hemorrhage at the first menstruation six months after delivery. Uterine arteriovenous fistulas were diagnosed by color Doppler ultrasonography (US), dynamic computer tomography (CT), and conventional angiography. The patient underwent hysterectomy after bloodstream decrease by bilateral uterine artery embolization...
2010: Clinical and Experimental Obstetrics & Gynecology
Rajib Das, Kamran Ahmed, Thanos Athanasiou, Robert A Morgan, Anna-Maria Belli
PURPOSE: The use of arterial closure devices (ACDs) in interventional radiology (IR) procedures has not yet been validated by large-scale randomised controlled trials or meta-analysis. Improved haemostasis and early mobilisation are publicised advantages; however, anecdotal evidence of haemorrhagic and ischaemic complications with ACDs is also apparent. Meta-analysis from interventional cardiology cannot be directly extrapolated for IR patients. MATERIALS AND METHODS: Systematic review, performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines was performed to assess four ACDs: Angioseal; StarClose; Perclose; and Duettin peripheral vascular interventions: uterine artery embolisation, transhepatic chemoembolisation, and cerebral diagnostic and interventional procedures...
August 2011: Cardiovascular and Interventional Radiology
L L Batista, J Mahadevan, M Sachet, B Husson, J Rasmussen, H Alvarez, P Lasjaunias
We describe the case of a three-year-old Danish boy born at term by Cesarean due to cardiac insufficiency in the last trimestre of intra-uterine life for which he is being treated with cardiac drugs. At birth, he was noted to have bilateral ocular malformations on the upper eyelids, and diffuse scalp lipoma and alopecia. Due to the retarded growth (score - 3D) he had a MRI and angiography which demonstrated a high flow fistula on the basilar tip artery and another one on the MCA branch treated by endovascluar approach...
September 30, 2002: Interventional Neuroradiology
Na Guo, Hui Liu, Zhilan Peng
Uterine arteriovenous fistula is a rare, but potentially life-threatening condition that should be suspected in women of reproductive age with an unexplained vaginal bleeding. Uterine artery embolization, in contrast, is a safe and effective treatment for uterine arteriovenous fistula because it preserves the normal function of the uterus and the ovaries. The advantages of avoiding hysterectomy are clear, especially for young patients who want to preserve their reproductive function. Embolization failure is rare...
August 2010: Annals of Vascular Surgery
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