Percutaneous cardiopulmonary support for pulmonary thromboembolism caused by large uterine leiomyomata

Kurakazu, Masamitsu; Ueda, Taeko; Matsuo, Keitaro; Ishikura, Hiroyasu; Kumagai, Naoya; Yoshizato, Toshiyuki; Miyamoto, Shingo

doi:10.1016/j.tjog.2012.09.023

Cited by 12 publications

(5 citation statements)

References 14 publications

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“…About 77 studies were included in this review (Fig. 1) and were assessed for bias using Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses (19–95). Our review considered articles to have a low risk of bias if all checklist criteria were met, moderate risk if greater than or equal to 75% of criteria were met, and high risk if less than 75% of criteria were met.…”

Section: Methodsmentioning

confidence: 99%

Venoarterial Extracorporeal Membrane Oxygenation in Massive Pulmonary Embolism-Related Cardiac Arrest: A Systematic Review*

Scott

Gordon

Vender

et al. 2021

Critical Care Medicine

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OBJECTIVE: Management of patients experiencing massive pulmonary embolism-related cardiac arrest is controversial. Venoarterial extracorporeal membranous oxygenation has emerged as a potential therapeutic option for these patients. We performed a systematic review assessing survival and predictors of mortality in patients with massive PE-related cardiac arrest with venoarterial extracorporeal membranous oxygenation use. DATA SOURCES: A literature search was started on February 16, 2020, and completed on March 16, 2020, using PubMed, Embase, Cochrane Central, Cinahl, and Web of Science. STUDY SELECTION: We included all available literature that reported survival to discharge in patients managed with venoarterial extracorporeal membranous oxygenation for massive PE-related cardiac arrest. DATA EXTRACTION: We extracted patient characteristics, treatment details, and outcomes. DATA SYNTHESIS: About 301 patients were included in our systemic review from 77 selected articles (total screened, n = 1,115). About 183 out of 301 patients (61%) survived to discharge. Patients (n = 51) who received systemic thrombolysis prior to cannulation had similar survival compared with patients who did not (67% vs 61%, respectively; p = 0.48). There was no significant difference in risk of death if PE was the primary reason for admission or not (odds ratio, 1.62; p = 0.35) and if extracorporeal membranous oxygenation cannulation occurred in the emergency department versus other hospital locations (odds ratio, 2.52; p = 0.16). About 53 of 60 patients (88%) were neurologically intact at discharge or follow-up. Multivariate analysis demonstrated three-fold increase in the risk of death for patients greater than 65 years old (adjusted odds ratio, 3.08; p = 0.03) and six-fold increase if cannulation occurred during cardiopulmonary resuscitation (adjusted odds ratio, 5.67; p = 0.03). CONCLUSIONS: Venoarterial extracorporeal membranous oxygenation has an emerging role in the management of massive PE-related cardiac arrest with 61% survival. Systemic thrombolysis preceding venoarterial extracorporeal membranous oxygenation did not confer a statistically significant increase in risk of death, yet age greater than 65 and cannulation during cardiopulmonary resuscitation were associated with a three- and six-fold risks of death, respectively.

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Section: Methodsmentioning

confidence: 99%

Venoarterial Extracorporeal Membrane Oxygenation in Massive Pulmonary Embolism-Related Cardiac Arrest: A Systematic Review*

Scott

Gordon

Vender

et al. 2021

Critical Care Medicine

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“…There were two main goals of treatment, one was to stabilize and treat DVT and PE, and the other was to eliminate the predisposing factors, the tumor (7). According to the literature, there have been cases of giant uterine fibroids complicated by DVT and PE treated successfully; however, the majority of these patients received gynecologic surgery once the pulmonary embolism situation had stabilized (8)(9)(10)(11)(12)(13)(14)(15), as shown in Table 1. None of these cases guided the emergency treatment of vaginal prolapse with a large tumor and infection.…”

Section: Discussionmentioning

confidence: 99%

Case report: A case of perineal prolapse of giant uterine fibroids complicated by multiple pulmonary embolisms and deep venous thrombosis

Dong,

Sun,

et al. 2024

Front. Oncol.

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A 43-year-old woman with a history of uterine fibroids, anemia, and deep vein thrombosis presented with a chief symptom of prolapse of tumor from the perineum, complicated by infection. The case was further complicated by bilateral pulmonary multiple embolism, deep vein thrombosis, acute cardiac insufficiency, acute renal insufficiency, and shock. The patient was treated with preoperative placement of an inferior vena cava filter, open hysterectomy, and perioperative anticoagulation with low-molecular-weight heparin. She smoothly navigated the perioperative period and recovered completely.

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“…Most experts consider 10-centimeter diameter as large uterine leiomyoma [26]. Acute complications are rare; however when they do occur they can produce significant morbidity and affect a woman's quality of life [21, 27, 28]. Despite the frequency of uterine leiomyomas, its association with thromboembolic disease is uncommon and has been reported only in few case reports (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…This theory proposes that VTE occurs as a result of (1) hypercoagulability, either systemic or local, (2) stasis of the venous blood, and (3) vessel wall injury, specifically in the endothelium. The proposed mechanism by which a large uterine leiomyoma may be associated with thromboembolic events is thought to be extrinsic mechanical compression of surrounding structures, including the pelvic venous system, leading to stasis and subsequent thrombosis [21, 27]. …”

Section: Discussionmentioning

confidence: 99%

Should Prophylactic Anticoagulation Be Considered with Large Uterine Leiomyoma? A Case Series and Literature Review

Satti

Saenz

Raju

et al. 2016

Case Reports in Obstetrics and Gynecology

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Introduction. Uterine leiomyomas, also called uterine fibroids or myomas, are the most common pelvic tumors in women. They are very rarely the cause of acute complications. However, when complications occur they cause significant morbidity and mortality. Thromboembolic disease has been described as a rare complication of uterine leiomyomas. DVT is a serious illness, sometimes causing death due to acute PE. Cases. We report a case series of 3 patients with thromboembolic disease associated with uterine leiomyoma at Hurley Medical Center, Flint, Michigan, during 2015 and conduct a literature review on the topic. A literature search was conducted using Medline, PubMed, and PMC databases from 1966 to 2015. Conclusion. The uterine leiomyoma is a very rare cause of PE and only few cases have been reported. DVT secondary to uterine leiomyoma should be considered in a female presenting with abdominal mass and pelvic pressure, if there is no clear common cause for her symptoms. Thromboembolic disease secondary to large uterine leiomyoma should be treated with acute stabilization and then hysterectomy. Prophylactic anticoagulation would be beneficial for lowering the risk of VTE in patients with large uterine leiomyoma.

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Percutaneous cardiopulmonary support for pulmonary thromboembolism caused by large uterine leiomyomata

Abstract: This case suggests that PCPS can lead to favorable clinical outcomes in patients with large uterine leiomyomata and severe PTE.

Cited by 12 publications

References 14 publications

Venoarterial Extracorporeal Membrane Oxygenation in Massive Pulmonary Embolism-Related Cardiac Arrest: A Systematic Review*

Venoarterial Extracorporeal Membrane Oxygenation in Massive Pulmonary Embolism-Related Cardiac Arrest: A Systematic Review*

Case report: A case of perineal prolapse of giant uterine fibroids complicated by multiple pulmonary embolisms and deep venous thrombosis

Should Prophylactic Anticoagulation Be Considered with Large Uterine Leiomyoma? A Case Series and Literature Review

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