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.

journal_name

Clin Radiol

journal_title

Clinical radiology

authors

Wang Z,Chen J,Shi H,Zhou K,Sun H,Li X,Pan J,Zhang X,Liu W,Yang N,Jin Z

doi

10.1016/j.crad.2011.11.002

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

541-5

issue

6

eissn

0009-9260

issn

1365-229X

pii

S0009-9260(11)00502-2

journal_volume

67

pub_type

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