Transradial Uterine Artery Embolization Complicated by Stroke

Wu, Richard; Peters, Gail L.; Charles, H.; Kokabi, Nima; Bercu, Zachary L.; Majdalany, Bill S.

doi:10.1055/s-0042-1759700

Cited by 1 publication

(1 citation statement)

References 35 publications

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“…1 Known risks include nontarget embolization, paradoxical embolus in the setting of migration into the venous system, and access site complications, 1,8,[19][20][21] including a small risk of stroke via transradial access. 32 There is a theoretical risk of uterine necrosis based on studies of UAE for uterine myomas, although this complication has not been specifically documented in the setting of UVA. 1,11 The effects on fertility are also unknown, with numerous studies reporting successful and uncomplicated pregnancies post-UAE for UVA, although an actual fertility rate is difficult to ascertain due to small sample sizes.…”

Section: Adverse Eventsmentioning

confidence: 99%

Uterine Vascular Anomalies: Management and Treatment Overview

Matsumoto,

Caridi

2023

Semin intervent Radiol

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Uterine vascular anomalies (UVAs), while rare, can result in severe, life-threatening hemorrhage. An understanding of the presentation and management options for UVAs is important for interventional radiologists to appropriately evaluate and care for these patients. The authors propose a standardized terminology for UVAs to avoid confusion and conflating congenital from acquired vascular lesions, which have a different pathophysiology. Limited high-level evidence and no definitive guidelines for UVA management exist, although endovascular treatment with uterine artery embolization has generally become the first-line approach for symptomatic or persistent UVAs with high technical and clinical success rates. There is also no consensus on the optimal embolization technique; the authors propose an initial approach to first embolize the dominant uterine artery supplying the UVA with gelatin sponge, with the option to embolize the contralateral side at the time of initial embolization if there is persistent supply (avoiding bilateral empiric embolization). Repeat embolization is feasible and recommended in the setting of recurrence, and both clinical and imaging follow-up is important. Ultimately, a multidisciplinary approach with individualized patient management is needed, particularly in the face of a lack of consensus guidelines for the management of symptomatic UVAs.

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