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Uterine embolization

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https://www.readbyqxmd.com/read/29777846/an-academic-tertiary-referral-center-s-experience-with-a-vascular-surgery-based-uterine-artery-embolization-program
#1
Naiem Nassiri, Adrian Balica, Nolan C Cirillo-Penn, Dustin Tyler Crystal, Gloria A Bachmann
OBJECTIVE: Despite growing endovascular experience within the vascular surgery community, some catheter-based interventions - such as uterine artery embolization (UAE) - remain outside the clinical scope of most vascular surgeons, owing in part to established referral patterns and limited awareness among referring colleagues. We present our experience with a vascular surgery-based, multidisciplinary UAE program at an academic tertiary referral center. METHODS: In a collaborative effort between vascular surgery and gynecology, a Pelvic Vascular Disease Program has been established to provide palliative, prophylactic, and therapeutic embolizations including, but not limited to, UAE...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772407/total-laparoscopic-hysterectomy-for-endometriosis-and-an-arteriovenous-malformation
#2
Emilie Schwartz, Emilie Faller, Chérif Youssef Akladios, Michel Greget, Catherine Roy, Arnaud Wattiez
STUDY OBJECTIVE: Demonstrate a laparoscopic management of an arteriovenous malformation in a patient with deep pelvic endometriosis DESIGN: A step-by-step explanation of the surgery using video (instructive video). SETTING: Hautepierre Universitary Hospital of Strasbourg in France INTERVENTION: We describe the case of a 37 years old patient presenting deep pelvic endometriosis and an uterine arteriovenous malformation. It was during a tubal ligation in 2015, that the deep pelvic endometriosis was diagnosed...
May 14, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29772406/fertility-pregnancy-and-clinical-outcomes-after-uterine-arteriovenous-malformation-management
#3
Sophie Delplanque, Maela Le Lous, Maïa Proisy, Yolaine Joueidi, Estelle Bauville, Celine Rozel, Eugénie Beraud, Bertrand Bruneau, Jean Levêque, Vincent Lavoué, Krystel Nyangoh Timoh
STUDY OBJECTIVE: To evaluate fertility, pregnancy, and clinical outcomes after uterine arteriovenous malformation (UAVM) management. DESIGN: Single-center retrospective study from January 2000 to July 2017. (Canadian task force III). SETTING: One referral center. PATIENTS: Twenty-two patients with a UAVM diagnosed by Magnetic Resonance Angiography (MRA) or Computed Tomography (CT) angiography and managed by Expectant Management (EM) or Uterine Arterial Embolization (UAE) during the study period were included...
May 14, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29750955/the-comparing-options-for-management-patient-centered-results-for-uterine-fibroids-compare-uf-registry-rationale-and-design
#4
Elizabeth A Stewart, Barbara L Lytle, Laine Thomas, Ganesa R Wegienka, Vanessa Jacoby, Michael P Diamond, Wanda K Nicholson, Raymond M Anchan, Sateria Venable, Kedra Wallace, Erica E Marsh, George L Maxwell, Bijan J Borah, William H Catherino, Evan R Myers
OBJECTIVE: To design and establish a uterine fibroid (UF) registry based in the United States (US) to provide comparative effectiveness data regarding UF treatment. STUDY DESIGN: We report here the design and initial recruitment for the Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF) registry (Clinicaltrials.gov, NCT02260752), funded by the Agency for Healthcare Research and Quality (AHRQ) in collaboration with the-Patient-Centered Outcomes Research Institute (PCORI)...
May 8, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29750127/a-potentially-useful-addition-to-predict-spontaneous-resolution-of-uterine-artery-pseudoaneurysm-absence-of-diastolic-flow
#5
Yosuke Baba, Hironori Takahashi, Hiroyuki Morisawa, Daisuke Matsubara, Kohei Tamura, Rie Usui, Shigeki Matsubara
Pregnancy-associated uterine artery pseudoaneurysm (UAP) usually requires transarterial embolization (TAE) irrespective of the presence/absence of current bleeding. Some UAP cases spontaneously resolve without TAE; however, such UAP is not well characterized. Here, we suggest that Pulse Wave Doppler may become an addition to predict its spontaneous resolution. A woman underwent 1st-trimester vaginal termination. Vaginal bleeding repeated and, 36 days later, an intrauterine low-echoic mass (24 mm) with swirling blood flow and arterial waveforms (Pulse Wave Doppler) and an enhanced intrauterine sac-like structure without current extravasation were observed, leading to the diagnosis of UAP...
2018: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29747267/-application-of-uterine-lower-part-breakwater-like-suture-operation-in-placenta-previa
#6
Y Zhao, J W Zhu, D Wu, Q H Wang, S S Lu, X X Liu, L Zou
Objective: To explore the efficacy and safety of uterine lower posterior wall breakwater-like suture technique in controlling the intraoperative bleeding of placenta previa. Methods: From June 2016 to June 2017, 47 patients were diagnosed placenta previa in Union Hospital, Tongji Medical College of Huazhong University of Science and Technology. Posterior wall breakwater-like suture technique was used preferentially, as for cases with poor myometrium layer, lower anterior wall stitch suture was used at the same time...
April 25, 2018: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29730079/hysteroscopic-management-of-cervical-pregnancy-case-series-and-review-of-the-literature
#7
Vasilios Tanos, Sayed ElAkhras, Baris Kaya
PURPOSE: To evaluate the hysteroscopic management on cervical pregnancy. MATERIALS AND METHODS: A case series report and literature review on patients with early first trimester cervical pregnancy (CP) treated by hysteroscopy. The symptoms upon admission, β-hCG levels, hysteroscopy technique, blood loss and operation outcomes were presented. RESULTS: Four patients with early CP between 5-7 weeks were successfully managed with operative hysteroscopy...
May 3, 2018: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29724419/acr-appropriateness-criteria-%C3%A2-radiologic-management-of-uterine-leiomyomas
#8
M-Grace Knuttinen, Gregory Stark, Eric J Hohenwalter, Linda D Bradley, Aaron R Braun, Matthew G Gipson, Charles Y Kim, Jason W Pinchot, Matthew J Scheidt, David M Sella, Clifford R Weiss, Jonathan M Lorenz
Uterine fibroids, also known as leiomyomas, are the most common benign tumor in women of reproductive age. When symptomatic, these patients can present with bleeding and/or bulk-related symptoms. Treatment options for symptomatic uterine leiomyomas include medical management, minimally invasive treatment such as uterine artery embolization, and surgical options, such as myomectomy. It is important to understand the role of these treatment options in various clinical scenarios so that appropriate consultation is performed...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29718837/therapeutic-approach-for-the-cesarean-scar-pregnancy
#9
Li-Ping Fu
The aim of this study was to explore the pros and cons of different treatments of cesarean scar pregnancy (CSP).We retrospectively studied 205 cases of CSP that were treated in our hospital from June 2013 to June 2014, 189 of which had surgical operation.The average age of the patients was (32.98 ± 4.56) years. Data from those 189 cases were analyzed.Two hundred five patients from Beijing Obstetrics and Gynecology Hospital.One hundred eighty-nine cases who had operative treatment, 111 of which received curettage under hysteroscopy, 70 of which received curettage under ultrasonography, 8 of which received laparoscopic Cesarean scar resection...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29693012/management-of-cesarean-scar-pregnancy-a-single-institution-retrospective-review
#10
P Giampaolino, N De Rosa, I Morra, A Bertrando, A Di Spiezio Sardo, B Zizolfi, C Ferrara, L Della Corte, G Bifulco
Objective: Cesarean scar pregnancy (CSP) is a rare condition that occurs when the pregnancy implants in a cesarean scar. An early diagnosis and a proper management are fundamental to prevent maternal complications. We review and discuss the different treatment employed in our unit to reduce morbidity, preserve fertility, and predict possible complications. Methods: The reported treatment has been expectant management, operative hysteroscopy approach, and intramuscular injection of 50 mg methotrexate (MTX), followed by cervical dilation and manual vacuum aspiration (D&S) with a Karman cannula under ultrasound guidance, uterine artery embolization (UAE), and manual vacuum aspiration under ultrasound guidance and uterine artery embolization before surgical laparotomic resection...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29692958/role-of-uterine-artery-embolization-in-pseudoaneurysm-of-uterine-artery-a-rare-cause-of-secondary-postpartum-hemorrhage
#11
Saraswathy Subramaniam, Chandran Nadarajan, Mohd E Aziz
Uterine artery pseudoaneurysm is an uncommon cause of secondary postpartum hemorrhage, although it carries a high mortality rate. The etiology includes vascular trauma during cesarean section, vaginal delivery, curettage or hysterotomy. We present a post-cesarean female who developed delayed hemorrhage and was diagnosed with left uterine artery pseudoaneurysm. Selective transcatheter arterial embolization was performed and the pseudoaneurysm was successfully obliterated. Angiographic embolization is a safe and efficient method of treatment of postpartum hemorrhage due to pseudoaneurysm in hemodynamically stable patients...
February 23, 2018: Curēus
https://www.readbyqxmd.com/read/29686554/diagnosing-and-treating-postpartum-uterine-artery-pseudoaneurysm
#12
Kathlyn Parr, Anisha Hadimohd, Adrianne Browning, Jason Moss
Uterine artery pseudoaneurysm (UAP) is an uncommon cause of postpartum hemorrhage. We present a case of a 19-year-old woman 6 weeks postpartum after low transverse cesarean delivery with recurrent heavy vaginal bleeding requiring a blood transfusion. Transvaginal sonogram revealed a UAP. Embolization of the uterine artery was performed, with resolution of her symptoms.
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29675497/a-case-report-of-ggeneralized-uterine-arteriovenous-malformation-after-molar-pregnancy-in-an-infertile-woman
#13
Firoozeh Ahmadi, Somayeh Moukhah
Background: Uterine arteriovenous malformation (UAVM) is a rare vascular condition in reproductive age presented mostly with bleeding. Although this malformation is infrequent, it is potentially life-threatening. Transvaginal Doppler ultrasonography is a widely available, noninvasive and excellent diagnostic method. Case: The case is a 30-yr-old woman with a history of eight-yr infertility.following intrauterine insemination treatment, she had a molar pregnancy...
February 2018: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/29673673/the-application-of-uterine-wall-local-resection-and-reconstruction-to-preserve-the-uterus-for-the-management-of-morbidly-adherent-placenta-case-series
#14
Xianlan Zhao, Ya Tao, Yingying Du, Lei Zhao, Cai Liu, Yan Zhou, Peng Wei
OBJECTIVE: We aimed to evaluate our experience with the application of uterine wall local resection and reconstruction to preserve the uterus in patients with morbidly adherent placenta. MATERIALS AND METHODS: In a retrospective study, data from patients with morbidly adherent placenta who delivered by cesarean section between January 1, 2013 and May 31, 2016 were analyzed. Prophylactic abdominal aorta balloon occlusion and tourniquet were used to prevent massive hemorrhage in all 62 cases, followed by uterine wall local resection and reconstruction to preserve the uterus...
April 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29649369/women-with-newly-diagnosed-uterine-fibroids-treatment-patterns-and-cost-comparison-for-select-treatment-options
#15
Machaon M Bonafede, Scott K Pohlman, Jeffrey D Miller, Ellen Thiel, Kathleen A Troeger, Charles E Miller
The primary objective of this study was to describe surgical treatment patterns among women with newly diagnosed uterine fibroids (UF). A secondary objective was to estimate the medical costs associated with other common surgical interventions for UF. Claims-based commercial and Medicare data (2011-2016) were used to identify women aged ≥30 years with continuous enrollment for at least 12 months before and after a new diagnosis of UF. Receipt of a surgical or radiologic procedure (hysterectomy, myomectomy, endometrial ablation, uterine artery embolization, and curettage) was the primary outcome...
March 2018: Population Health Management
https://www.readbyqxmd.com/read/29628616/updates-on-uterine-artery-embolization
#16
REVIEW
Maureen P Kohi, James B Spies
Uterine fibroids (leiomyomas) are the most common benign neoplasm of the female pelvis and have a lifetime prevalence exceeding 80% among African American women and approaching 70% among Caucasian women. Approximately 50% of women with fibroids experience symptoms which may include menorrhagia that may result in anemia, bulk symptoms with bladder and bowel dysfunction and abdominal protrusion, dysmenorrhea, and infertility. Hysterectomy remains the most common treatment option for fibroids and concerns have been raised about the overuse of this procedure...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628615/pelvic-artery-embolization-for-treatment-of-postpartum-hemorrhage
#17
REVIEW
Jonathan D Lindquist, Robert L Vogelzang
Postpartum hemorrhage (PPH) is the leading cause of maternal perinatal morbidity and mortality worldwide. Defined as greater than 500 mL blood loss after vaginal delivery, and greater than 1,000 mL blood loss after cesarean delivery, PPH has many causes, including uterine atony, lower genital tract lacerations, coagulopathy, and placental anomalies. Correction of coagulopathy and identification of the cause of bleeding are mainstays of treatment. Medical therapies such as uterotonics, balloon tamponade, pelvic artery embolization, and uterine-sparing surgical options are available...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29623551/classification-of-uterine-artery-angiographic-images-a-predictive-factor-of-failure-in-uterine-artery-embolization-for-postpartum-hemorrhage
#18
Eisuke Ueshima, Koji Sugimoto, Takuya Okada, Naoto Katayama, Yutaka Koide, Keitaro Sofue, Mayumi Morizane, Kenji Tanimura, Masashi Deguchi, Masato Yamaguchi
PURPOSE: To justify a classification system for angiographic images of uterine artery embolization (UAE) for postpartum hemorrhage (PPH) and identify new risk factors associated with failed embolization. MATERIALS AND METHODS: A retrospective analysis of 63 consecutive patients who underwent UAE for severe PPH was performed. Uterine artery angiography (UA) before embolization was classified into two types: type 1 was defined as complete staining and type 2 was defined as partial staining of the uterine arteries...
April 5, 2018: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29622362/clinical-outcomes-of-23-patients-who-had-repeat-pelvic-arterial-embolisation-for-uncontrolled-post-partum-haemorrhage-at-a-single-centre
#19
W Choi, J H Shin, P H Kim, K Han, J Y Ohm, J H Kim, J W Kim
AIM: To evaluate the safety and efficacy of repeated pelvic arterial embolisation (PAE) for uncontrolled postpartum haemorrhage (PPH) after a single session of PAE and to compare angiographic findings between the two sessions of PAE. MATERIALS AND METHODS: A total of 23 consecutive patients (age range, 23-44 years) who underwent repeated PAE for uncontrolled PPH between March 2001 and January 2016 in Severance Hospital were reviewed. The interval times between the two sessions of PAE, the angiographic findings, embolic materials, arteries embolised during PAE, and the clinical outcomes were reviewed retrospectively...
April 2, 2018: Clinical Radiology
https://www.readbyqxmd.com/read/29604603/vaginal-spindle-cell-epithelioma-a-first-complete-mri-and-histopathologic-description
#20
Michael T Johnson, Kristin C Smith, Leo L Tsai
Spindle cell epithelioma of the vagina is a benign entity with fewer than sixty cases described in the literature, and only two with limited imaging findings, since the early 1950s. Early pathology literature suggested the lesions were mixed tumors of myoepithelial origin, but subsequent studies have found relatively few immunohistochemical characteristics in common with other mixed cell tumors. More recently, Mullerian, urogenital sinus epithelial, and pluripotential cell origins have been proposed. Given lesion rarity and a typical lack of imaging before excision, the imaging appearance of vaginal spindle cell epitheliomas has not been fully described in the radiology literature, and without comprehensive pathology correlation...
March 27, 2018: Clinical Imaging
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