Estimation of fetal radiation absorbed dose during the prophylactic use of aortic occlusion balloon for abnormally invasive placenta

Nieto-Calvache, Álbaro José; Salas, Luis; Duran, E; Benavides, S. O.; Ordóñez, Carlos A.; Rodríguez-Holguín, Fernando

doi:10.1080/14767058.2019.1678144

Cited by 7 publications

(9 citation statements)

References 14 publications

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“…Aortic balloon deflation and subsequent reperfusion can lead to potential cardiovascular complications 29 . The radiation dose can be decreased with aortic occlusion but with an associated risk of severe complications 32 . Placement of the occlusion balloons in the common iliac arteries can be performed even without X-ray exposure under ultrasound guidance, but with a higher risk of thromboembolic complications and risks of retrograde flow into the internal iliac arteries 33 .…”

Section: Discussionmentioning

confidence: 99%

Estimating the radiation dose to the fetus during prophylactic internal iliac occlusion in patients with abnormal placentation

Černá¹,

Huml²,

Köcher³

et al. 2021

BIOMED PAP

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Aims. To evaluate the estimated fetal radiation dose during prophylactic internal iliac arterial occlusion in patients with abnormal placenta and to estimate the risk of radiation induced cancer in child age. Methods. Prophylactic occlusion of the internal iliac arteries during Caesarean section was performed in 42 patients with placenta praevia and/or placenta accreta spectrum. Fogarty embolectomy catheters were used for prophylactic occlusion of the internal iliac arteries. All procedures were performed in the hybrid operating room using Philips Allura Xper FD 20 X-ray system. Low dose X-ray fluoroscopy (7.5 frames per second) was used. The CODE (Conceptus dose estimation) Software was used to estimate the fetal dose and the risk of radiation induced carcinoma. Results. Fluoroscopy times required for insertion of Fogarty catheters were 0.5-4.2 min (mean: 1.7 min, median: 1.5 min). The estimated radiation dose to the fetus was 0.26-3.36 mGy (mean: 1.49 mGy, median: 1.25 mGy). The risk of radiation induced cancer in child age was 0.01-0.04% (mean 0.02%, median 0.01%). One patient developed thrombosis of a common femoral artery. Conclusion. Prophylactic occlusion of the internal iliac arteries is a simple and safe procedure with minimal risk of complications and with a very low estimated radiation dose to the fetus.

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Section: Discussionmentioning

confidence: 99%

Estimating the radiation dose to the fetus during prophylactic internal iliac occlusion in patients with abnormal placentation

Černá¹,

Huml²,

Köcher³

et al. 2021

BIOMED PAP

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“…Fetal radiation dose with temporary aortic balloon occlusion varies among studies. Duan et al reported a fetal radiation dose of 4.2±2.9 (SD) mGy (40) but Nieto-Calvache reported entrance skin dose and radiation absorbed dose by the fetus of 1.31±0.96 (SD) mGy and 0.27±0.28 (SD) mGy, respectively in 10 women with AIP using C-arm (119).…”

Section: Prophylactic Balloon Occlusion Of the Abdominal Aortamentioning

confidence: 99%

The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences

Soyer¹,

Barat²,

Loffroy³

et al. 2020

Quant Imaging Med Surg

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Abnormally invasive placenta (AIP) is a potentially severe condition. To date, arterial embolization in women with postpartum hemorrhage due to AIP is the treatment option for which highest degrees of evidence are available. However, other techniques have been tested, including prophylactic catheter placement, balloon occlusion of the iliac arteries and abdominal aorta balloon occlusion. In this systematic review, we provide an overview of the currently reported interventional radiology procedures that are used for the treatment of postpartum hemorrhage due to AIP and suggest recommendations based on current evidences. Owing to a high rate of adverse events, prophylactic occlusion of internal iliac arteries should be used with caution and applied when the endpoint is hysterectomy. On the opposite, when a conservative management is considered to preserve future fertility, uterine artery embolization should be the preferred option as it is associated with a hysterectomy rate of 15.5% compared to 76.5% with prophylactic balloon occlusion of the internal iliac arteries and does not result in fetal irradiation. Limited data are available regarding the application of systematic prophylactic embolization and no comparative studies with arterial embolization are available.

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“…Two recent meta-analyses demonstrated that aortic balloon occlusion reduced intraoperative blood loss, transfusion requirements and the need for caesarean hysterectomy in PAS with low procedure-related complication rates, ranging from 1.7% to 2.2% [ 6 , 7 ]. Widespread adoption of this technique has been limited by the need for access to interventional radiology expertise, equipment and angiography suites, along with ionizing radiation exposure to staff, patient and fetus [ 13 ]. Here, a safe and practical technique is presented using intravascular ultrasound (IVUS) for aortic balloon insertion to facilitate uterine conservation in a case of severe PAS.…”

Section: Introductionmentioning

confidence: 99%

Use of an aortic balloon to achieve uterine conservation in a case of placenta accreta spectrum: A case report

Bartels

Brophy

Moriarty

et al. 2023

Case Reports in Women's Health

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Estimation of fetal radiation absorbed dose during the prophylactic use of aortic occlusion balloon for abnormally invasive placenta

Cited by 7 publications

References 14 publications

Estimating the radiation dose to the fetus during prophylactic internal iliac occlusion in patients with abnormal placentation

Estimating the radiation dose to the fetus during prophylactic internal iliac occlusion in patients with abnormal placentation

The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences

Use of an aortic balloon to achieve uterine conservation in a case of placenta accreta spectrum: A case report

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