Temporary balloon occlusion of the common iliac artery: New approach to bleeding control during cesarean hysterectomy for placenta percreta

Interventional radiology for critical hemorrhage in obstetrics: Japanese Society of Interventional Radiology (JSIR) procedural guidelines

“…Thus, this indication is still controversial [32,[41][42][43][44][45][46][47][48]. Patients with fibroids and multiple pregnancies may be indicated for prophylactic IR, though only three cases with successful bleeding control have been reported.…”

“…Hematoma at the puncture site. (Grade C1) Specific comments [22,26,32,[41][42][43][44][45][46][47][48] Complications from prophylactic insertion of occlusion balloon catheters include angiography, thromboembolic events, and damaged balloons resulting in the failure of efficient occlusion of the arteries. The safe radiation dose for the fetus has not been reported; however, the reported fluoroscopy time was less than 5 min; thus, the dose is estimated as <50 mGy.…”

Study of the utility and problems of common iliac artery balloon occlusion for placenta previa with accreta

“…Multivariate analysis of risk factors for blood loss during CH revealed that CIABO is an independent factor for reducing blood loss during CH in patients with placenta previa with accreta. Since Shih et al .’s study,13 a number of reports have demonstrated the efficacy of CIABO,14, 15 while Sinan et al . reported that there was no significant difference in intraoperative blood loss or transfusion between 25 patients who underwent CH with and 27 who underwent CH without the use of CIABO for placenta previa with accreta 16.…”

“…reported that intraoperative bleeding in patients with placenta previa with accreta could be reduced by placing a balloon occlusion catheter in the common iliac artery for temporary blood flow occlusion during CH 13. Therefore, since 2006, we have been performing balloon occlusion catheter placement in the common iliac artery (common iliac artery balloon occlusion, CIABO) in surgery for placenta previa with accreta.…”

Optimal strategies for conservative management of placenta accreta: a review of the literature

“…31,[43][44][45] As Clark et al reported that ligation of the hypogastric arteries failed to control obstetric hemorrhage in more than half of the examined cases, 46) balloon occlusion in the internal iliac arteries seems less effective due to the extensive network of collateral vessels. So, balloon inflation in the common iliac artery has been gradually used for patients with placenta accreta since Shih et al's 47,48) first report. This can overcome collateral flow from the external iliac and femoral arteries and is attributed to significant reductions of intraoperative blood loss.…”