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

Munteanu, Octavian; Secară, Diana C.; Neamtu, Maria Narcisa; Baroş, Alexandru; Dimitriade, Adela; Dorobăț, Bogdan; Carp, Alexandra; Mutu, Daniela Elena Gheoca; Cîrstoiu, Monica Mihaela

doi:10.3390/diagnostics12061436

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Transcatheter artery embolization (TAE) especially uterine artery embolization (UAE) is widely used in the treatment of gynecological and gynecological diseases, such as uterine fibroids, postpartum hemorrhage, scar pregnancy, and pelvic trauma, due to its advantages of small trauma, rapid hemostasis, and accurate positioning ( 3 ). Some studies have pointed out that the most common responsible vessels in Pelvic artery embolization (PAE) of postpartum hemorrhage are uterine artery, followed by internal iliac artery, circular ligament artery, and ovarian artery ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

The clinical application of transarterial embolization via radial artery in hemorrhagic diseases in obstetrics and gynecology

Ma,

Chen,

Luo

et al. 2023

Front. Med.

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PurposeThe present study aimed to explore the feasibility and safety of Transarterial embolization (TAE) in the treatment of obstetrics and gynecological hemorrhagic diseases transradial approach (TRA) compared to transfemoral approach (TFA).MethodsThis cohort study was conducted on patients with obstetrics and gynecology bleeding diseases from June 2021 to November 2022. Clinical characteristics of the patients were comparable between the two groups. The success rate of puncture and embolization, radiation dose, operation time, fluoroscopy time (FT), as well as complications of each patient were recorded and then retrospectively analyzed the data. The European Five-dimensional Health Scale (ED-5Q) and visual analog scale (VAS) were used to assess the quality of life (QOL) on the day of discharge and 30 days after surgery between the two groups.ResultsA total of 71 patients undergoing TAE were allocated to the TRA (n = 31) or TFA (n = 40) group in this study. Puncture and embolization were completed in all patients. Compared to the TFA group, the radiation dose of the TRA group (343.89 ± 108.81 mGy vs. 469.29 ± 198.66 mGy; p = 0.029) is significantly reduced. Minor complications occurred in only one patient (3.2%) in the TRA group. The surgery-related quality of life EQ-5D index score on the day of discharge in the TRA group (0.72 ± 0.12 vs. 0.65 ± 0.11; p = 0.017) was significantly higher than that in the TFA group, and the VAS score (2.55 ± 0.62 vs. 2.95 ± 0.85; p = 0.025) of catheter site discomfort was significantly lower in the TRA group were than in the TFA group, but no significant difference was observed in the QOL assessment at 30 days post-surgery.ConclusionTransradial approach TAE has comparable efficacy and safety to TFA TAE in treating obstetrics and gynecological bleeding diseases. This access can improve patient QOL without affecting surgical safety.

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Section: Introductionmentioning

confidence: 99%

The clinical application of transarterial embolization via radial artery in hemorrhagic diseases in obstetrics and gynecology

Ma,

Chen,

Luo

et al. 2023

Front. Med.

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“…Генитально-анальная зона подвержена относительно меньшему количеству случаев встречаемости ангиоматоза и составляет при этом 1,5-2% [13][14][15].…”

Section: Introductionunclassified

Minimally invasive treatment modalities for venous dysplasias in the anogenital region

Bogachev,

Boldin,

Samenkov

2023

Ambulatornaya khirurgiya

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Venous malformations are the most type of angiodysplasia, which cause both physiological and emotional discomfort to patients. In this article, the authors presented a clinical example of effectiveness combined foam form sclerotherapy and laser photocoagulate with Intensive Pulsed Light therapy and show a long-term outcome in a patient with superficial venous malformation of her anogenital area, which are accompanied with such symptoms as pain and bleeding. As a sclerosing agent, a 1 and 3% sodium tetradecyl sulphate solution was used. The interval between procedures was 6 weeks. After two sessions, the superficial venous malformations of the anogenital area decreased in the size and volume, and the patient presented less complaints. After the first stage of treatment, which includes sclerotherapy, then 3 sessions of laser photocoagulate were performed, with an interval between sessions from 1.5 months. Ultrasound angioscanning allows us to assess the degree of regression of venous dysplasia, cavities and cavities of the pathological process. Ultrasound is a minimally invasive and affordable diagnostic method that, in addition to universality, excludes the component of psychoemotional discomfort. This is due to the absence of a large routine during the study with the application of any physical or mental impact on the body and the patient as a whole. The main advantage is the possibility of implementing minimally invasive treatment at the outpatient stage, with the possibility of combination therapy, both in a hospital stay, and in commercial and private medical centers. The combination of foam sclerotherapy with percutaneous laser coagulation (plus IPL therapy) in this clinical case demonstrates the effectiveness and safety in localizing the pathological process in the anogenital region. The obtained result demonstrates the absence of malformation growth and complications in the form of repeated bleeding with a good cosmetic effect in the medium and long term.

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Chronic compartment-syndrome of the lower limb: modern strategies for diagnosis and treatment

Katorkin

Kushnarchuk

2023

Ambulatornaya khirurgiya

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A review of the literature is presented, including data on the incidence, pathophysiology, and clinical picture of patients with chronic compartment syndrome (CCS) of the lower extremities. Chronic exercise compartment syndrome (CECS) is characterized by pain with repetitive exertion and increased intracompartmental pressure affecting the lower extremities in physically active patients. In severe chronic venous insufficiency of the lower extremities, chronic venous compartment syndrome (CVCS) develops, which is fundamentally different from previously known clinical pictures. Progressive dermatolipofasciosclerosis and cicatricial destruction of the fascia of the leg in patients with C4b-C6 clinical classes according to CEAP affect the pressure in the muscle-fascial compartments at each step. In severe cases, this leads to significant changes in the muscles, accompanied by chronic ischemia associated with necrosis and glycogen deficiency. The analysis of various diagnostic methods, conservative treatment and methods for performing surgical decompression of the CCS was carried out. The lack of a clear pathophysiology for CECS and CVCS complicates the diagnosis and treatment of this condition. Diagnosis of calf CCS is still based on pressure testing in the musculofascial compartments of the calf using the Pedowitz criteria, however standard procedures for this, including patient position, static or dynamic movements, muscles and equipment tested, are not agreed upon. In patients with CCS, if conservative treatment is ineffective, fasciotomy of the affected parts of the lower leg is the method of choice. Various techniques for fasciotomy of the lower leg include the traditional open fasciotomy, the semi-closed technique with one or more incisions, the minimally invasive technique using endoscopic compartment release, and the use of ultrasound guidance. Fasciectomy of the lower leg to correct CVCS is performed mainly for recurrence of trophic ulcers after shave therapy, severe calcification of the lower leg tissues and for the treatment of deep transfascial necrosis. Randomized, blinded, controlled trials are needed to further expand our knowledge of the diagnosis and treatment of CCS.

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

Cited by 3 publications

References 23 publications

The clinical application of transarterial embolization via radial artery in hemorrhagic diseases in obstetrics and gynecology

The clinical application of transarterial embolization via radial artery in hemorrhagic diseases in obstetrics and gynecology

Minimally invasive treatment modalities for venous dysplasias in the anogenital region

Chronic compartment-syndrome of the lower limb: modern strategies for diagnosis and treatment

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