Efficacy and safety of embolization in iatrogenic traumatic uterine vascular malformations.

Abstract

AIM:

To retrospectively evaluate the efficacy of embolotherapy in patients with iatrogenic traumatic uterine arteriovenous malformations (AVMs).

MATERIALS AND METHODS:

A retrospective review of all patients who underwent uterine arterial embolization in Peking Union Medical College Hospital between January 2000 and December 2010 was performed. Forty-two patients were diagnosed with a uterine vascular malformation. All patients had obstetric manipulations before. Serial beta-human chorionic gonadotropin (β-HCG) levels were measured to exclude gestational trophoblastic neoplasia. All patients underwent transcatheter embolization of bilateral uterine arteries. The complications, control of haemorrhage, and outcome of subsequent pregnancies were assessed.

RESULTS:

A total of 49 embolization procedures were performed in 42 patients. Seven patients required repeated embolizations for recurrence of bleeding. The technical success rate of embolization was 100%. Bleeding was controlled in 35 of 42 patients (83%) after the first embolization procedures, and bleeding was controlled in another two patients who underwent repeat embolization at a median follow-up of 29 months (range 3 months to 5 years). The overall clinical success rate was 88% (37/42). Thirteen patients subsequently became pregnant and eight of 13 patients had uneventful intrauterine pregnancies carried to term. Seven patients had post-embolization syndrome and no other complication occurred.

CONCLUSION:

Percutaneous embolotherapy is a safe and effective treatment for traumatic AVMs. Future pregnancy is still possible after embolization.

• Authors: Z Wang, J Chen, H Shi, K Zhou, H Sun, X Li, J Pan, X Zhang, W Liu, N Yang, Z Jin
• Journal: Clinical radiology (Clin Radiol) Vol. 67 Issue 6 Pg. 541-5 (Jun 2012) ISSN: 1365-229X [Electronic] England
• PMID: 22261390 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Gelatin

Topics

• Adolescent
• Adult
• Embolization, Therapeutic (methods)
• Female
• Follow-Up Studies
• Gelatin (therapeutic use)
• Hemorrhage (therapy)
• Humans
• Iatrogenic Disease
• Middle Aged
• Pregnancy
• Pregnancy Complications (therapy)
• Radiography, Interventional (methods)
• Recurrence
• Retreatment
• Retrospective Studies
• Treatment Outcome
• Uterus (blood supply, injuries)
• Vascular Malformations (therapy)
• Young Adult