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Uterine embolization

John DeMeritt, Ethan Wajswol, Anoop Wattamwar, Babak Litkouhi, Ami Vaidya, Michael Sbarra, Stacy Zamudio, Rocio Acera Pozzi, Andrew Canning, John Woytanowski, Abdulla Al-Khan
Two patients with placenta percreta underwent uterine artery embolization (UAE) for abnormally invasive placenta (AIP) in the first trimester. Patient 1 had a 9-week cervical ectopic, while Patient 2 had a 9-week cesarean scar pregnancy. Elective termination of pregnancy was performed in both patients. UAE was performed with tris-acryl gelatin microspheres as well as gelfoam until stasis and was repeated in cases of revascularization. Both patients were followed with US/MRI/MRA scans and β-hCG levels. Revascularization occurred in both patients following UAE, requiring multiple embolizations to achieve complete placental involution...
March 19, 2018: Cardiovascular and Interventional Radiology
Margit Dueholm
The aim of the present review is to give a comprehensive overview of minimal invasive treatment options and suggest a minimally invasive approach in women with adenomyosis (AD). A review of relevant literature on medical and surgical treatment options is performed. Surgical options include endometrial ablation, hysteroscopic endometrial and adenomyoma resection, laparoscopic resection of AD, high-intensity focused ultrasonography (HIFU), and uterine artery embolization (UAE). This review summarizes treatment strategies for the management of AD and highlights the present lack of knowledge, which makes suggestions of evidence-based treatment difficult...
February 15, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Amartuvshin Tumenjargal, Hiroyuki Tokue, Hiroshi Kishi, Hiromi Hirasawa, Ayako Taketomi-Takahashi, Yoshito Tsushima
PURPOSE: To investigate the efficacy and safety of uterine artery embolization (UAE) followed by dilation and curettage (D&C) as a treatment for cesarean scar pregnancy (CSP) and to assess pregnancy outcomes after the treatment. MATERIALS AND METHODS: We retrospectively analyzed 33 CSP patients treated with UAE followed by D&C. The serum level of beta human chorionic gonadotropin (β-hCG) normalization, hospitalization, menstruation, and successful pregnancy after treatment was assessed as clinical and pregnancy outcomes...
March 15, 2018: Cardiovascular and Interventional Radiology
Guang-Shao Cao, Rui-Qing Liu, Yu-Yan Liu, Jian-Wen Liu, Lu-Peng Li, Qiang Zhang, Hui-Cun Cao, Tian-Xiao Li
This study aims to investigate the menstrual recovery outcome of scar pregnancy patients who received uterine artery embolization combined with curettage, and its influencing factors.The data of 119 patients with scar pregnancy, who received uterine artery embolization combined with curettage between December 2012 and December 2016 in Henan Provincival People's Hospital, were collected. The menstruation recovery of these patients was followed up, and factors that have influence on menstrual blood volume were analyzed using SPSS V...
March 2018: Medicine (Baltimore)
Dirk Schnapauff, Manon Russ, Thomas Kröncke, Matthias David
PURPOSE:  Purpose of this paper to present results of a group of 21 consecutive patients who underwent uterine artery embolization (UAE) immediately before myomectomy. Surgical myomectomy can lead to a substantial blood loss in case of large or multiple tumors due to the hypervascularization of the tumors. This may lead to multiple blood transfusion or hysterectomy. In cases were the preservation of the uterus is demanded, pre-operative embolization could reduce the risk of substantial bleeding...
March 7, 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Anna Maria Ierardi, Valeria Savasi, Salvatore Alessio Angileri, Mario Petrillo, Sara Sbaraini, Antonio Pinto, Francesco Hanozet, Anna Maria Marconi, Gianpaolo Carrafiello
Uterine fibroids are the most common benign pelvic tumor of the female genital tract and tend to increase with age; they cause menorrhagia, dysmenorrhea, pelvic pressure symptoms, back pain, and subfertility. Currently, the management is based mainly on medical or surgical approaches. The nonsurgical and minimally invasive therapies are emerging approaches that to the state of the art include uterine artery embolization (UAE), image-guided thermal ablation techniques like magnetic resonance-guided focused ultrasound surgery (MRgFUS) or radiofrequency ablation (RF), and percutaneous microwave ablation (PMWA)...
2018: BioMed Research International
Zhen-Bo Ouyang, Song Quan
No abstract text is available yet for this article.
March 5, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
Annefleur Machteld de Bruijn, Paul Nm Lohle, Judith Af Huirne, Jolanda de Vries, Moniek Twisk, Wouter Jk Hehenkamp
BACKGROUND: Adenomyosis is a benign uterine disease characterized by invasion of endometrium into the myometrium resulting in heavy menstrual bleeding and pain (dysmenorrhea). Hysterectomy is established as the final treatment option when conservative treatment fails. Uterine artery embolization (UAE) in patients with symptomatic adenomyosis has demonstrated to reduce symptoms and improve quality of life. However, randomized controlled trials are lacking. OBJECTIVE: With this study, we aim to evaluate the impact of UAE on Health-Related Quality of Life (HRQOL) in a randomized comparison to hysterectomy in patients with symptomatic adenomyosis...
March 1, 2018: JMIR Research Protocols
Ge'er Zhang, Zimin Pan
OBJECTIVE: To analyze the clinical features, diagnosis and treatment of gestational trophoblastic diseases in cesarean scar. METHODS: Clinical data of three cases of gestational trophoblastic diseases in cesarean scar diagnosed in Women's Hospital, Zhejiang University School of Medicine during December 2011 and December 2016 were collected. And literature search was performed in Wanfang data, VIP, CNKI, PubMed, ISI Web of Knowledge and EMbase database. RESULTS: A total of 20 cases of gestational trophoblastic diseases were included in the analysis...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
F Alabdulghani, A O'Brien, D Brophy
One of the main causes of failure in uterine fibroid embolization procedures is incomplete infarction of the fibroid due to alternate vascular supply to the fibroid which was not identified by the operator. Cone-beam computed tomography angiography was used in this case to avoid nontarget embolization via a uterine artery, as well as identify incomplete embolization of the fibroid. This prompted a search for variant vascular supply to the fibroid, which was found to be originating from the right ovarian artery...
February 2018: Radiology Case Reports
Eveline Thomaere, Michiel Dehairs, Annouschka Laenen, Abdoli Mehrsima, Dirk Timmerman, Sandra Cornelissen, Katya Op de Beeck, Hilde Bosmans, Geert Maleux
Background Uterine fibroid embolization (UFE) is a minimally invasive imaging-guided treatment using radiation exposure. Purpose To compare the patients' radiation exposure during UFE before and after introduction of a new X-ray imaging platform. Material and Methods Forty-one patients were enrolled in a prospective, comparative two-arm project before and after introduction of a new X-ray imaging platform with reduced dose settings, i.e. novel real-time image processing techniques (AlluraClarity). Demographic, pre-interventional imaging, and procedural data, including dose area product (DAP) and estimated organ dose on the ovaries and uterus, were recorded and angiographic quality of overall procedure was assessed...
January 1, 2018: Acta Radiologica
Piotr Szkodziak, Filip Szkodziak, Kamila Trzeciak, Piotr Czuczwar
Uterine fibroids are benign uterine tumors. In women during the reproductive period, uterine fibroids occur in about 25%, whereas after this time, they are observed in more than 40% of women. In the majority of women (about 20-50%), such tumors do not cause discomfort and do not require treatment. Asymptomatic uterine fibroids usually undergo only regular medical control, whereas symptomatic fibroids are an indication for treatment. Current treatment methods include surgical, pharmacological and minimally invasive treatment...
December 2017: Przeglad Menopauzalny, Menopause Review
Hiroki Hayashi, Kazunori Ishikawa, Hideaki Mori, Mitsuhiro Kamiyoshihara
A 50-year-old woman visited a previous hospital because of aphasia. She was diagnosed as having cardiogenic embolism and left ventricular thrombus. Anticoagulant therapy was performed but was unsuccessful because of hypermenorrhea due to the myoma of the uterus. She was transferred to our hospital to receive surgical treatment. After uterine myomectomy, we performed video-assisted transaortic left ventricular thrombectomy. Her postoperative course was uneventful. Left ventriculotomy has been the standard approach for left ventricular thrombectomy...
February 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Novera G Chughtai, Raheela Mohsin Rizvi
The management of puerperal hematomas after normal delivery has always been challenging for obstetricians. Vulvar, vulvovaginal, or paravaginal hematomas are common. On the other hand, retroperitoneal hematomas are uncommon and can be life-threatening. The diagnosis of vascular injury is rarely made preoperatively as atonic or traumatic postpartum hemorrhage (PPH), uterine rupture and amniotic fluid embolism are more common differential diagnoses. Injury to internal pudendal and uterine vessels is extremely rare in cases of vaginal delivery and, therefore, the literature on this topic is very scarce...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Arshia Javed, Reeta Chander, Zahra Hoodbhoy
Uterine arteriovenous malformation (AVM) is an uncommon but life-threating source of bleeding. AVM is an abnormal connection between uterine arteries and veins. Patients typically present with vaginal bleeding following miscarriage (medical/surgical) or cesarean section. The treatment of choice depends on the symptoms, age, desire of fertility, localization and size of the lesion. Uterine artery embolization is the first choice in symptomatic patients of reproductive age group. We report a case of AVM presenting after dilation and evacuation with extensive lesion, which was successfully treated with bilateral uterine artery embolization...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Yong Seek Kim, Kichang Han, Man-Deuk Kim, Gyoung Min Kim, Joon Ho Kwon, Junhyung Lee, Woosun Choi, Jong Yun Won, Do Yun Lee
PURPOSE: To evaluate safety and efficacy of uterine artery embolization (UAE) for pedunculated subserosal (PS) leiomyomas. MATERIALS AND METHODS: Of 1,069 patients who underwent UAE for symptomatic leiomyomas or adenomyosis from 2007 to 2016, 55 patients (mean age 40.3 y ± 4.8) with 66 PS leiomyomas (mean diameter 6.61 cm ± 2.04) were enrolled. Each PS leiomyoma was categorized into 1 of 2 groups: high-risk PS leiomyoma (stalk diameter < 25% of diameter of leiomyoma) and low-risk PS leiomyoma (stalk diameter 25%-50% of diameter of leiomyoma)...
February 22, 2018: Journal of Vascular and Interventional Radiology: JVIR
Shohei Okazaki, Takanori Abe, Natsuko Takayanagi, Masanori Yasuda, Fumikazu Sakai, Kunihiko Kobayashi, Shingo Kato
BACKGROUND/AIM: We report on a case of pulmonary tumor embolism caused by squamous cell carcinoma of the uterine cervix. PATIENTS AND METHODS: A 60-year-old female diagnosed with stage IVB (cT4N1M1) squamous cell carcinoma of the uterine cervix was admitted to our institution with a chief complaint of progressive dyspnea that developed within a few days after admission. RESULTS: A chest CT scan showed dilated pulmonary arteries, right ventricular enlargement and mosaic ground-glass opacities in both lungs...
March 2018: In Vivo
Nicholas Xiao, Jonathan Lindquist, Robert L Vogelzang
This case series illustrates a radial access complication seen in 7 of 9 consecutive patients (age range, 44-53 y) undergoing uterine artery embolization in May and June 2017. Demonstrative images and videos identify a transient and clinically consequential skin ischemia caused by intraprocedural saline solution infusion through the occlusive radial artery sheath. All complications documented were classified as mild adverse events (class A) according to Society of Interventional Radiology criteria. Complication severity ranged from transient blanching to ischemic necrosis of the skin...
March 2018: Journal of Vascular and Interventional Radiology: JVIR
Cheng Shi Chen, Sohee Park, Ji Hoon Shin, Yasir Nouri, Jong-Woo Kim, Hyun-Ki Yoon, Gi-Young Ko
Background Endovascular treatment has become a significant therapeutic option for the management of intractable bleeding in gynecologic malignancies. However, the endovascular treatment types were almost never mentioned when active bleeding from different arteries was identified. Purpose To present angiographic details and evaluate clinical efficacy of endovascular treatments to control active vaginal bleeding in uterine cervical cancer patients treated with radiotherapy. Material and Methods In this retrospective study, six, consecutive cervical cancer patients treated with radiotherapy who underwent endovascular treatment for active vaginal bleeding were included...
January 1, 2018: Acta Radiologica
Inger Keussen, Johan Bengtsson, Dolores Gavier-Widén, Erika Karlstam
Background Transarterial embolization with particles is a relatively common treatment method in both malignant and benign disorders. Permanent occlusion of the uterine arteries may sometimes be disadvantageous. Purpose To compare the local tissue effects, possible side effects, and extent of recanalization following uterine artery embolization, using either degradable or non-degradable microspheres in a sheep model. Material and Methods In 22 female sheep, the uterine artery (UA) was unilaterally, superselectively embolized, with either degradable starch microspheres-DSM (group A) or calibrated gelatin coated spherical shape tris-acryl microspheres-TGMS (group B)...
January 1, 2018: Acta Radiologica
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