Uterine Artery Embolization: Background Review, Patient Management, and Endovascular Treatment

Dehbozorgi, Arshan; Frenette, Aaron; Alli, Adam; Ash, Ryan; Rohr, Aaron

doi:10.1016/j.jradnu.2020.07.007

Cited by 2 publications

(7 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of uterine leiomyomas varies between 25% and 80%, being one of the most common benign pelvic tumors in women, which develop between menarche and menopause [ 6 , 7 ]. Although many of the patients are asymptomatic, approximately 25% of them suffer from menorrhagia and secondary iron deficiency anemia, dysmenorrhea, fertility issues, urinary frequency and constipation [ 6 , 8 ]. Submucosal leiomyomas are most associated with vaginal hemorrhage [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although many of the patients are asymptomatic, approximately 25% of them suffer from menorrhagia and secondary iron deficiency anemia, dysmenorrhea, fertility issues, urinary frequency and constipation [ 6 , 8 ]. Submucosal leiomyomas are most associated with vaginal hemorrhage [ 6 ]. Besides the fact that PAE is used preoperatively in patients with uterine leiomyomas to reduce hemorrhage during surgery, it can also be used as an individual therapy to cease vaginal bleeding in elected patients with this symptomatology, as an alternative to surgical option [ 2 , 6 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Submucosal leiomyomas are most associated with vaginal hemorrhage [ 6 ]. Besides the fact that PAE is used preoperatively in patients with uterine leiomyomas to reduce hemorrhage during surgery, it can also be used as an individual therapy to cease vaginal bleeding in elected patients with this symptomatology, as an alternative to surgical option [ 2 , 6 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some of its advantages are the characteristic of being safe, rapid, repeatable, the absence of general anesthesia, avoiding difficulties during surgery, reduced complication rates, short hospital stays, shorter recovery time and earlier return to activities in comparison with other techniques [ 1 , 3 , 6 , 9 ]. It also allows the doctor to visualize the origin of the bleeding, thus permitting targeted embolization and preservation of the uterus and its reproductive function [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…There are some complications of using this kind of procedures, such as angiography related complications (hematoma, pseudoaneurysm or arteriovenous fistula at the site of catheter insertion), infection (such as endometrial or tubo-ovarian abscess, endometritis, urinary tract infection), urinary retention, amenorrhea, uterine infarction and ischemia [ 2 , 6 , 9 ]. If bilateral internal iliac artery embolization is performed, there may appear complications such as skin necrosis, neurological dysfunction, bladder necrosis, thrombosis and pain [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Our Experience in Using the Endovascular Therapy in the Management of Hemorrhages in Obstetrics and Gynecology

et al. 2022

View full text Add to dashboard Cite

(1) Background: A quarter of maternal deaths are caused by post-partum hemorrhage; hence obstetric bleeding is a significant cause of morbidity and mortality among women. Pelvic artery embolization (PAE) represents a minimally invasive interventional procedure which plays an important role in conservative management of significant bleeding in Obstetrics and Gynecology. The aim of this study was to evaluate the effect and the complications of PAE in patients with significant vaginal bleeding with different obstetrical and gynecological pathologies. (2) Methods: We conducted an observational, retrospective study on 1135 patients who presented to the University Emergency Hospital of Bucharest with vaginal bleeding of various etiology treated with endovascular therapy. All the patients included in the study presented vaginal hemorrhage that was caused by: uterine leiomyomas, genital tract malignancies, ectopic pregnancy, arterio-venous mal-formations and other obstetrical causes. We excluded patients with uncontrolled high blood pressure, severe hepatic impairment, congestive heart failure, renal failure or ventricular arrhythmias. (3) Results: Bleeding was caused in 88.19% of cases by uterine leiomyomas (n = 1001), 7.84% (n = 89) by cervical cancer, 2.29% by ectopic pregnancy (n = 26), 1.23% by arteriovenous malformation (n = 14) and 0.52% by major hemorrhage of obstetrical causes. Endovascular procedures were used in all the cases. In patients with uterine leiomyomas, supra-selective uterine arteries embolization was used. In 97% (n = 1101) of patients, bleeding was stopped after the first attempt of PAE. 3% (n = 34) needed a second embolization. In 12 of 14 cases of AVM, PAE was successful, two other cases needed reintervention; (4) Conclusions: Endovascular procedures represent a major therapy method for both acute and chronic hemorrhage in Obstetrics and Gynecology. It can be used in post-partum or post-traumatic causes of vaginal bleeding, but also in patients with chronic hemorrhage from uterine leiomyomas or inoperable genital malignancies or even as a preoperative adjuvant in cases of voluminous uterine fibroids or invasive malignant tumors, aiming to reduce intraoperative hemorrhage.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Our Experience in Using the Endovascular Therapy in the Management of Hemorrhages in Obstetrics and Gynecology

et al. 2022

View full text Add to dashboard Cite

show abstract

Parameter effects on arterial vessel sonicated by high-intensity focused ultrasound: an ex vivo vascular phantom study

Huang¹,

Zhou²,

Li³

et al. 2022

Phys. Med. Biol.

View full text Add to dashboard Cite

Objective. This study is aimed to explore the effects of vascular and sonication parameters on ex vivo vessel sonicated by high-intensity focused ultrasound. Approach. The vascular phantom embedding the polyolefin tube or ex vivo vessel was sonicated. The vascular phantom with 1.6 and 3.2 mm tubes was sonicated at three acoustic powers (2.0, 3.5, 5.3 W). The occlusion level of post-sonication tubes was evaluated using ultrasound imaging. The vascular phantom with the ex vivo abdominal aorta of rabbit for three flow rates (0, 5, 10 cm s−1) was sonicated at two acoustic powers (3.5 and 5.3 W). Different distances between focus and posterior wall (2, 4, 6 mm) and cooling times (0 and 10 s) were also evaluated. The diameter of the sonicated vessel was measured by B-mode imaging and microscopic photography. Histological examination was performed for the sonicated vessels. Main results. For the 5 cm s−1 flow rate, the contraction index of vascular diameter (Dc) with 5.3 W and 10 s cooling time at 2 mm distance was 39 ± 9% (n = 9). With the same parameters except for 0 cm s−1 flow rate, the Dc was increased to 45 ± 7% (n = 4). At 3.5 W, the Dc with 5 cm s−1 flow rate was 23 ± 15% (n = 4). The distance and cooling time influenced the lesion along the vessel wall. Significance. This study has demonstrated the flow rate and acoustic power have the great impact on the vessel contraction. Besides, the larger lesion covering the vessel wall would promote the vessel contraction. And the in vivo validation is required in the future study.

show abstract

Uterine Artery Embolization: Background Review, Patient Management, and Endovascular Treatment

Cited by 2 publications

References 15 publications

Our Experience in Using the Endovascular Therapy in the Management of Hemorrhages in Obstetrics and Gynecology

Our Experience in Using the Endovascular Therapy in the Management of Hemorrhages in Obstetrics and Gynecology

Parameter effects on arterial vessel sonicated by high-intensity focused ultrasound: an ex vivo vascular phantom study

Contact Info

Product

Resources

About