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Uterine embolization

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https://www.readbyqxmd.com/read/28536870/benign-metastasizing-leiomyomas-following-myomectomy-and-uterine-artery-embolization
#1
Jessica Yoon, James B Spies, Theresa M Caridi
Benign metastasizing leiomyomas (BMLs) are rare sequelae of common uterine leiomyomas and most frequently found in the lungs. Most cases of BMLs occur with a history of prior gynecologic procedures; however, none have yet been reported in association with uterine artery embolization (UAE). This case report highlights the disease course for a 48-yo female with a history of both myomectomy and UAE for uterine fibroids who presented later with bilateral pulmonary BMLs. Though the pathophysiology of BMLs is poorly understood and this case is confounded by prior myomectomy, it does bring into question whether UAE has a role in BML development...
May 23, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28534017/delayed-postpartum-hemoperitoneum-due-to-uterine-artery-pseudoaneurysm-rupture
#2
Kyu-Sang Kyeong, Ji-Yeon Moon, Song-Hwa Chae, Seung Hwa Hong, Minho Kang, Eun-Hwan Jeong
A 30-year-old woman experienced severe abdominal pain 8 days after vaginal delivery. The patient was diagnosed with hemoperitoneum due to rupture of the left uterine artery pseudoaneurysm, which was confirmed via ultrasound with color Doppler and computed tomography scans. This patient was treated with bilateral uterine artery embolization to maintain fertility. A uterine artery pseudoaneurysm that causes delayed postpartum hemorrhage can occur after cesarean section or vaginal delivery. A uterine artery pseudoaneurysm can be fatal, so its detection and diagnosis are critical...
May 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28516272/uterine-artery-embolization-for-symptomatic-adenomyosis-7-year-clinical-follow-up-using-ufs-qol-questionnaire
#3
Annefleur M de Bruijn, Marieke Smink, Wouter J K Hehenkamp, Robbert J Nijenhuis, Albert J Smeets, Focco Boekkooi, Paul J H M Reuwer, Willem J Van Rooij, Paul N M Lohle
PURPOSE: The purpose of this study was to assess clinical outcomes 7 years after uterine artery embolization (UAE) in the treatment of symptomatic adenomyosis. MATERIALS AND METHODS: In this prospective cohort study, one specialized hospital in the Netherlands recruited patients with symptomatic adenomyosis or adenomyosis in combination with fibroids for UAE. The 7-year post-intervention outcomes were health-related quality of life (HRQOL), symptom severity scores (SSS), satisfaction, menopause and re-interventions...
May 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28508254/comparison-of-pain-within-24%C3%A2-h-after-uterine-artery-embolization-with-tris-acryl-gelatin-microspheres-versus-gelatin-sponge-particles-for-leiomyoma
#4
Tetsuya Katsumori, Hisatomi Arima, Shunsuke Asai, Natsuko Hayashi, Hiroshi Miura
PURPOSE: To compare acute pain after uterine artery embolization (UAE) with tris-acryl gelatin microspheres (TAGM) versus gelatin sponge particles (GS) for leiomyoma. MATERIALS AND METHODS: This was a single-institution, retrospective study. Between July 2008 and November 2016, 101 consecutive patients with symptomatic uterine leiomyoma underwent UAE with the same protocol for post-procedural pain. GS was employed with near-stasis endpoint for the first 49 patients, whereas TAGM was used with limited endpoint for the next 52 patients...
May 15, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28491172/acquired-uterine-arteriovenous-fistula-following-dilatation-and-curettage-an-uncommon-cause-of-vaginal-bleeding
#5
Adam Evans, Roland E Gazaille, Richard McKenzie, Meghan Musser, Robert Lemming, Jarrod Curry, William Meyers, Nicholas Austin
Dysfunctional uterine bleeding is a common presentation of women in the emergency department. We describe the case of a 33-year-old female who presented with intermittent spotting due to an acquired uterine AVF. The patient underwent a transvaginal pelvic ultrasound as well as a CT angiogram. The patient was treated conservatively and elected to undergo uterine artery embolization in an effort to preserve fertility. She successfully delivered a healthy baby boy at 39-week gestation via an emergent caesarian section due to a prolapsed umbilical cord 17 months after undergoing the uterine artery embolization...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28491165/carbon-dioxide-angiography-and-arterial-embolization-could-successfully-control-postpartum-uterine-hemorrhage-for-the-patient-with-hypersensitivity-to-iodine-compound
#6
Sayaka Kawashita, Masanori Kaneuchi, Daisuke Nakayama, Naoki Fuchi, Yuko Murakami, Kiyonori Miura, Hideaki Masuzaki
Transcatheter arterial embolization has become a common management option for intractable postpartum uterine hemorrhage. Iodinated contrast agents are commonly used for embolotherapy but cannot be used in patients with renal dysfunction or iodine allergy. A 37-year-old woman spontaneously delivered a healthy girl but developed severe postpartum uterine hemorrhage, probably due to placenta accrete. Contrast-enhanced computed tomography revealed extravasation of the iodinated contrast agent into the uterine cavity...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28479027/leiomyoma-infarction-after-uterine-artery-embolization-influence-of-embolic-agent-and-leiomyoma-size-and-location-on%C3%A2-outcome
#7
Eduardo A Lacayo, Danielle L Richman, Michael R Acord, Darcy J Wolfman, Theresa M Caridi, Sameer Y Desale, James B Spies
PURPOSE: To study the factors that might impact infarction of individual uterine leiomyomas and total tumor burden after uterine artery embolization (UAE). MATERIALS AND METHODS: This retrospective study included 91 patients (mean age, 44 y [range, 34-54 y]) who underwent UAE with tris-acryl gelatin microspheres (TAGMs) or nonspherical polyvinyl alcohol (PVA) particles. Twenty-one patients were treated with PVA (23%) and 70 were treated with TAGMs (77%). A total of 356 uterine leiomyomas were assessed, with a median uterine volume of 533 cm(3) (range, 321-848 cm(3))...
May 4, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28472704/the-treatment-of-cesarean-scar-pregnancy-with-uterine-artery-embolization-and-curettage-as-compared-to-transvaginal-hysterotomy
#8
Huihui Chen, Jieru Zhou, Husheng Wang, Weilin Tan, Min Yao, Xipeng Wang
OBJECTIVES: To investigate the outcome and menstrual status in patients after treatment of cesarean scar pregnancy (CSP) by transvaginal hysterotomy or uterine artery embolization combined with uterine curettage. STUDY DESIGN: A retrospective cohort study. An analysis of CSP patients was performed using records from Shanghai First Maternity & Infant Hospital affiliated with Tongji University for the period between July 16, 2014 and January 22, 2016. Twenty-seven patients were treated with transvaginal hysterotomy and in this group, 49 patients received uterine curettage after UAE...
April 20, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28471117/antepartum-hemorrhage-from-previous-cesarean-sectioned-uterus-as-a-potential-sign-of-uterine-artery-pseudoaneurysm
#9
Ning Zhang, Wei-Hua Lou, Xue-Bin Zhang, Jian-Hua Lin, Wen Di
Postpartum hemorrhage (PPH), a leading cause of maternal mortality, can occur within 24 h of delivery (primary PPH), or during the period from 24 h after delivery to Week 6 of puerperium (secondary PPH). It requires health professionals to be alert to the symptoms to ensure prompt diagnosis and treatment, especially in the case of rupture of a uterine artery pseudoaneurysm (UAP) due to its life-threatening consequence (Baba et al., 2014). Most of the published case reports or case serials describe UAP as a possible cause of delayed PPH after traumatic procedures during delivery or pregnancy termination, including cesarean section (CS), manual removal of the placenta, or dilation and curettage (D&C) (Wald, 2003)...
May 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28466646/ultrasound-guided-transvaginal-thrombin-injection-of-uterine-arteries-pseudoaneurysms
#10
Cristina Ros, Daniel Barnes, Anna Fervienza, Gabriella Oses, Juan Luis Alcázar, Sergio Martínez-Román, Àngels Rovirosa, Francisco Carmona, Fernando Gómez
OBJECTIVE: To evaluate the utility of transvaginal ultrasound-guided thrombin injection (UGTI) to treat uterine artery pseudoaneurysms (UAP) as an alternative to emergency arterial embolization. METHODS: Two women presenting with heavy vaginal bleeding were diagnosed with UAP by pelvic CT scan. After UAP identification by transvaginal ultrasound (TVUS), 2 cc of thrombin (Tissucol(®), Baxter Healthcare Corporation. Munich, Germany) were slowly injected into the UAP using a 30 cm long 22-gauge needle through a needle-guide attached to the vaginal probe...
May 3, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28462440/safety-and-efficacy-of-uterine-artery-embolization-in-ectopic-pregnancies-refractory-to-systemic-methotrexate-treatment-a-single-center-study
#11
Joon Ho Kwon, Gyoung Min Kim, Kichang Han, Man Deuk Kim, Jong Yun Won, Do Yun Lee
BACKGROUND: To investigate the use of uterine artery embolization (UAE) to manage ectopic pregnancies that are refractory to systemic methotrexate (MTX) therapy and plagued by persistently high serum β-human chorionic gonadotrophin (hCG) levels and vaginal bleeding. The safety and efficacy of UAE were addressed. MATERIALS AND METHODS: A retrospective review was conducted for thirteen patients (mean age 35.2 years; range 28-41 years), who were treated between December 2006 and June 2016...
May 1, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28457758/radiation-dose-reduction-during-uterine-fibroid-embolization-using-an-optimized-imaging-platform
#12
Ryan Kohlbrenner, K Pallav Kolli, Andrew G Taylor, Maureen P Kohi, Evan D Lehrman, Nicholas Fidelman, Miles Conrad, Jeanne M LaBerge, Robert K Kerlan, Robert Gould
PURPOSE: To assess radiation dose reduction during uterine fibroid embolization (UFE) using an optimized angiographic processing and acquisition platform. MATERIALS AND METHODS: Radiation dose data for 70 women (mean age, 46 y; range, 34-67 y) who underwent UFE were retrospectively analyzed. Twenty-one patients underwent UFE using the baseline fluoroscopic and angiographic image acquisition platform, and 49 underwent UFE after implementing an optimized imaging platform in otherwise identical angiography suites...
April 27, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28446939/management-of-uterine-artery-pseudoaneurysm-advanced-ultrasonography-imaging-and-laparoscopic-surgery-as-an-alternative-method-to-angio-computed-tomography-and-transarterial-embolization
#13
Michał Ciebiera, Aneta Słabuszewska-Jóźwiak, Kornelia Zaręba, Grzegorz Jakiel
Uterine artery pseudoaneurysms (UAP) are rare but potentially life-threatening lesions. They may occur after traumatic deliveries, cesarean sections, and other interventions. We present a case of a 39-year-old woman with a UAP. The patient was accurately diagnosed using ultrasound imaging, with subsequent diagnostic hysteroscopy and laparoscopic excision of the UAP. In the present case, a ligation of the artery branch was performed to provide accurate hemostasis during UAP dissection. The vascular lesion was partially enucleated and removed, followed by recreation of the previous uterine shape...
2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/28439193/hysteroscopic-management-of-uterine-arteriovenous-malformation
#14
Stefano Calzolari, Mauro Cozzolino, Eleonora Castellacci, Valeria Dubini, Alfonso Farruggia, Giovanni Sisti
BACKGROUND AND OBJECTIVES: Uterine arteriovenous malformation (AVM) is characterized by shunts between the myometrial arteries and veins. Treatment is based on the severity of uterine bleeding and ranges from conservative medical approaches to embolization of affected arteries. The aim of study was to evaluate the feasibility and safety of hysteroscopy for management of uterine AVM. METHODS: This was a retrospective study of a cohort of 11 cases occurring between March 2012 and December 2015 in our Regional Center of Excellence in Hysteroscopy, University of Florence...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28437039/uterine-artery-pseudoaneurysm-bleeding-one-decade-after-caesarean-section-a-case-report
#15
Liza Johannesson, Jennifer Mason, Martin K Oehler
Uterine artery pseudoaneurysm (UAP) can cause severe secondary post-partum hemorrhage. The lag time between the triggering event and the manifestation of UAP reportedly usually occurs within a couple of weeks. In this case report, a 46-year-old woman with no significant comorbidities presented with a one-month history of increasing lower abdominal pain. She had previously undergone two cesarean sections (14 and 10 years earlier). A computed tomography angiogram revealed a left UAP. The patient was successfully treated by selective embolization and had an uneventful recovery...
April 24, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28420498/intraoperative-aortic-balloon-occlusion-in-patients-with-placenta-previa-and-or-placenta-accreta-a-retrospective-study
#16
Fangyuan Luo, Lan Xie, Ping Xie, Siwei Liu, Yue Zhu
OBJECTIVE: To introduce the primary experience of using aortic balloon catheters during cesarean section for placenta previa and/or placenta accreta. MATERIALS AND METHODS: From January 2013 to May 2015, 43 patients who were preoperatively diagnosed with major placenta previa and/or placenta accreta and who underwent prophylactic aortic catheterization before caesarean section (CS) were included in the study. We analyzed the clinical data of the study population...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28420496/the-value-of-hysteroscopic-management-of-cesarean-scar-pregnancy-a-report-of-44-cases
#17
Ying Pan, Mu-Biao Liu
OBJECTIVE: With the incidence of cesarean scar pregnancy (CSP) rising, the reports of serious adverse outcomes of it have increased gradually. The management of CSP remains an inadequately explored clinical field, and there is no consensus on it presently. The present study was performed to investigate the efficacy and safety of operative hysteroscopy in the diagnosis and treatment of CSP. MATERIALS AND METHODS: Forty-four patients with CSP underwent operative hysteroscopy for removal of scar ectopic pregnancy in our institution...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28403929/-conservative-placenta-percreta-management-using-uterine-arterial-embolization-procedure-a-series-of-12-cases
#18
C Hennetier, M Daudruy Brasseur, S Patrier, E Clavier, M L Thibault, E Verspyck
We report a retrospective series of 12 placentas percreta with bladder invasion and for which an expected initially multidisciplinary conservative surgical treatment associated with uterine artery embolization was programmed. Conservative surgical treatment was only performed in 7 women. Radical surgical treatment was necessary during the caesarean section and complicated by massive hemorrhage in three women and secondary in two other women for infectious diseases. Radical surgical treatment was associated with partial cystectomy complicated with urinary disorder sequelae in three women...
March 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28400997/congenital-uterine-arteriovenous-malformation-presenting-as-postcoital-bleeding-a-rare-presentation-of-a-rare-clinical-condition
#19
Neha Agarwal, Seema Chopra, Neelam Aggarwal, Ujjwal Gorsi
Congenital uterine arteriovenous malformation (AVM) is an extremely rare condition with <100 cases documented in literature. We report multiparous women presenting to us with a history of postcoital bleed. Initial Doppler ultrasonography was consistent with features suggestive of AVM. Subsequently, computed tomography (CT) angiography confirmed the diagnosis. Embolization was chosen as the treatment because of the large extension of AVM and the risk of hemorrhage during hysterectomy. The patient was discharged in a stable condition with a plan of repeat embolization in the next setting...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28397200/impact-of-pelvic-magnetic-resonance-imaging-findings-in-the-indication-of-uterine-artery-embolization-in-the-treatment-of-myoma
#20
Norma Maria Tenório Brito Pires, Emmanuelle Tenório Godoi, Dinaldo Cavalcanti Oliveira, Simone Cristina Soares Brandão, Carlos Coutinho Abath, Pedro Pires, Edward Araujo Júnior
OBJECTIVES: To assess the impact of pelvic magnetic resonance imaging (MRI) findings in the indication for uterine-artery embolization in women with fibroids, as well as the correlation between MRI and ultrasound (US) examinations for diagnosing adenomyosis. MATERIAL AND METHODS: A retrospective observational study was performed through the analysis of the medical records of 263 women referred for uterine-artery embolization as treatment for fibroids after undergoing US and MRI examinations...
2017: Ginekologia Polska
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