Efficacy of Embolization in Traumatic Uterine Vascular Malformations

Ghai, Sangeet; Rajan, Dheeraj K.; Asch, Murray; Muradali, Derek; Simons, Martin; terBrugge, Karel G.

doi:10.1097/01.rvi.0000096761.74047.7d

Cited by 142 publications

(136 citation statements)

References 35 publications

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“…2,8 Uterine AVMs can develop congenitally or may be acquired. 2,3 They are basically a proliferation of vascular channels of varying sizes with fistula formation along with tangle of capillary like vessels.…”

Section: Discussionmentioning

confidence: 99%

“…9 Congenital AVMs are more likely to extend beyond the confines of the uterus with supply from extra uterine pelvic arterial branches. 8 Acquired AVMs are more common of the two. They are abnormal communications between intramural arterial branches and myometrial venous plexus and thus essentially represent multiple tiny arteriovenous fistulas.…”

Section: Discussionmentioning

confidence: 99%

“…4 A supply from extra uterine arterial branches may also be encountered. 8 The various catheters which can be used for the purpose of embolization of the AVM are uterine artery catheter, RUC catheter, cobra catheter, renal curve catheter and coaxial microcathters. The embolization materials used are polyvinyl alcohol particles, nBCA and coils.…”

mentioning

confidence: 99%

“…The basis of selection of embolic material depends on the anatomic appearance of the vessels with rate of blood flow and expertise of the operator. 8 Major complications of the procedure include non-target embolization resulting in end organ damage, (viz pulmonary embolism), uterine necrosis, abscess formation and ovarian failure.…”

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confidence: 99%

“…8,14 The severity of hemorrhage in patients with uterine AVM determines the choice of management. The hemodynamic status of the patient at time of presentation essentially governs the timing of the procedure (emergency or elective).…”

mentioning

confidence: 99%

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Uterine arteriovenous malformation-beyond surgery: a case series

Pankar¹,

Indusekhar²,

Desai³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Uterine arteriovenous malformations (AVM) are a rare entity, presenting in women of reproductive age. The presentation may vary with bleeding being the chief presenting symptom. Though traditionally hysterectomy has been a definitive form of treatment, trans-catheter embolization is being considered as a good treatment option. We present three cases with uterine AVM who presented with heavy bleeding per vaginam. Three patients of reproductive age group (29-33 years) presented with heavy bleeding per vaginam from January 2017- May 2017. Two had previous miscarriages for which curettage was done and one had undergone a Caesarean section previously. Diagnosis of uterine AVM was made by ultrasound-grey scale, colour Doppler, followed by MRI. All patients underwent trans-catheter angiogram followed by selective embolization of the AVM with n-BCA (n- Butyl Cyanoacrylate) and polyvinyl alcohol (PVA) particles. Successful embolization was done in all of our patients with technical success rate of 100%. On follow-up, all patients are currently asymptomatic. Trans-catheter arterial embolization of uterine AVM is a simple and effective treatment alternative with less morbidity associated with anaesthesia and surgery in turn reducing hospital stay. It has to be considered in patients who need to preserve their fertility.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Uterine arteriovenous malformation-beyond surgery: a case series

Pankar¹,

Indusekhar²,

Desai³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Pregnancy after uterine arteriovenous malformation–case series and literature review

Eling

Kent

Robertson

2012

Australas J Ultrason Med

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Purpose: To perform a retrospective audit of cases of uterine arteriovenous malformations (UAVM) at The Canberra Hospital and review of recent literature reporting pregnancies occurring after the diagnosis of UAVM aiming to devise a diagnostic and treatment protocol to optimise pregnancy post UAVM. Methods: A retrospective audit of cases of UAVM at the Canberra Hospital from a prospectively managed patient database was performed. A search of the electronic database PubMed, for articles between 2000–2011 relating to pregnancy post UAVM. Individual case studies were analysed separately to case series. Results: The study included 28 individual studies and five case series (61 women). Average age was 29.5 ± 6.7 (range 18–42). Most women (24, 85.7%, 100% in case series) presented with abnormal vaginal bleeding; 11 (41%) individuals presented post interruption of pregnancy. All women had had a previous pregnancy (mean gravidity 3.1 ± 3.1, range 1–15 for case studies) and only four women (14.2 %) had no history of uterine trauma. Only one woman (3.6 %) did not have any ultrasound and most women underwent colour Doppler ultrasonography (20, 71.4% in case studies; 61, 83.6% in case series). Of the women, 72 (53.6 % of case studies, 78.1 % of case series) were treated with uterine artery embolisation, seven (25%) were treated expectantly. A total of 63 pregnancies occurred post treatment, seven (13.9%) ending in miscarriage. Average time to conceive post diagnosis was 19 months ± 16.3 (range 2–72). A total of 54 healthy infants were born to mothers post AVM diagnosis. Conclusion: UAVM are likely to exist on a continuum with other pregnancy related pathologies, such as sub involution of the placental bed, making a single best diagnostic and treatment plan difficult. However, this study shows that successful uncomplicated pregnancy is achievable for women after the diagnosis of UAVM.

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Percutaneous Management of Hemangiomas and Vascular Malformations

Marshalleck

Johnson

2006

Vascular Embolotherapy

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Efficacy of Embolization in Traumatic Uterine Vascular Malformations

Cited by 142 publications

References 35 publications

Uterine arteriovenous malformation-beyond surgery: a case series

Uterine arteriovenous malformation-beyond surgery: a case series

Pregnancy after uterine arteriovenous malformation–case series and literature review

Percutaneous Management of Hemangiomas and Vascular Malformations

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