Arterial anatomy of the female genital tract: variations and relevance to transcatheter embolization of the uterus.

Pelage, Jean-Pierre; Dref, Olivier Le; Soyer, Philippe; Jacob, Denis; Kardache, M; Dahan, H.; Lassau, J. P.; Rymer, Roland

doi:10.2214/ajr.172.4.10587133

Cited by 178 publications

(110 citation statements)

References 11 publications

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“…Our study showed a trend similar to the study from Kanasaki et al (24), with Type I as the most common (62.1%) anatomical variant. Pelage et al (25) looked into the division of the internal iliac artery, and their results corroborate our findings, with Type I and Type II origins noted in 77% of their cases, and 79% in ours. Interestingly, while in our study trifurcation origins (Type III) were noted in 14% of the patients, Gomez-Jorge et al (19) reported 43% Type III.…”

Section: Discussionsupporting

confidence: 91%

Three-dimensional rotational angiography is preferable to conventional two-dimensional techniques for uterine artery embolization

Gupta¹,

Zuurmond²,

Grünhagen³

et al. 2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to investigate the potential benefits of three-dimensional rotational angiography (3DRA) compared to two-dimensional (2D) roadmapping to visualize the uterine artery (UA) origins during uterine artery embolization (UAE) procedures. MATERIALS AND METHODSSixty-three UAE cases performed under 3DRA guidance were reviewed retrospectively to determine if there was an optimal angiographic projection angle for identifying UA origin. Digital subtraction angiogram (DAS)-like images of the pelvic vessels were generated from the 3DRA scans at six different angles: left anterior oblique (LAO) 25°, 35°, 45°; and right anterior oblique (RAO) 25°, 35°, 45°. Two experienced interventional radiologists assessed if these angles could effectively serve as a roadmap to guide catheterization of the UA. Assessment was validated against original 3DRA scans to determine the percentage of true and false positives. RESULTSNo single projection angle was found that could consistently be utilized for UA catheterization. The projection angles used during 3D roadmapping for both the left and right UA showed two clusters with both a wide spread: RAO 20° to 50° and LAO 20° to 50°. More than 50% of the DSA-like images at RAO and LAO 45° appeared to be adequate for UA catheterization, but validation against the 3DRA revealed 28% of these images were suboptimal and deceptive, due to unappreciated overlapping vessels. CONCLUSIONNo standard projection angles can be recommended with 2D roadmapping to consistently visualize UA origin. The 3DRA can be as a useful tool for UAE to achieve reliable and consistent visibility of the UA origin.

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Section: Discussionsupporting

confidence: 91%

Three-dimensional rotational angiography is preferable to conventional two-dimensional techniques for uterine artery embolization

Gupta¹,

Zuurmond²,

Grünhagen³

et al. 2013

Diagn Interv Radiol

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“…Meyers et al 4 reported successful TAE for 2 patients with avulsion of branches Massive postpartum hemorrhage is an obstetrical emergency that is usually controlled by using uterotonic medications, ligation of the uterine or hypogastric arteries, and/or TAE of the uterine arteries. 5,6 Our patient with postpartum hemorrhage following cesarean section delivery demonstrates that massive bleeding from the inferior epigastric artery directly related to injury of the artery during surgery can occur and that selective TAE of the inferior epigastric artery can help control extrauterine sources of bleeding.…”

Section: Discussionmentioning

confidence: 90%

“…It pierces the transversalis fascia and passes anterior to the arcuate line and ascends between the rectus abdominus muscle and posterior layer of the rectus sheath where it can have a relatively tortuous course. 5 As a result of its anatomy, the inferior epigastric artery may potentially be traumatized during percutaneous procedures. Lavery et al 12 reported embolization of the inferior epigastric artery after vascular trauma due to lateral trocar insertion at operative laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

Transarterial Embolization for Inferior Epigastric Artery Injury

Yalamanchili

Harvey

Friedman

et al. 2008

Vasc Endovascular Surg

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The inferior epigastric artery represents a potentially overlooked source of pelvic arterial hemorrhage. The authors describe 3 patients with massive inferior epigastric artery bleeding following cesarean section, paracentesis, and blunt trauma that were successfully treated with transarterial embolization. The inferior epigastric artery should be considered as a possible source of arterial hemorrhage if arteriography of internal iliac artery branches does not yield a bleeding source.

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“…Coaxially 2.9 F microcatheter (Embocath plus, Merit Medical Systems Inc., South Jordon, Utah, USA) was advanced into the uterine artery. The microcatheter tip was placed in the ascendant part of the uterine artery in order to avoid embolization of cervicovaginal branch [9]. No other catheter was used to reach the contralateral internal iliac and uterine artery.…”

Section: Resultsmentioning

confidence: 99%

Our Clinical Experience on Uterine Artery Embolization for the Treatment of Uterine Fibroids: A Retrospective Case-Series of 32 Patients

Yildiz¹

2017

OMICS J Radiol

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Arterial anatomy of the female genital tract: variations and relevance to transcatheter embolization of the uterus.

Cited by 178 publications

References 11 publications

Three-dimensional rotational angiography is preferable to conventional two-dimensional techniques for uterine artery embolization

Three-dimensional rotational angiography is preferable to conventional two-dimensional techniques for uterine artery embolization

Transarterial Embolization for Inferior Epigastric Artery Injury

Our Clinical Experience on Uterine Artery Embolization for the Treatment of Uterine Fibroids: A Retrospective Case-Series of 32 Patients

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