The Belarus Experience of Pelvic Artery Embolisation in Patients with Advanced and Recurrent Cervical Cancer Presenting with Haemorrhage

Matylevich, Olga P; Akinfeev, V; Randall, Thomas C.; Schmeler, Kathleen M.; Суконко, О. Г.

doi:10.17925/eoh.2018.14.1.45

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…Femoral, axillar, brachial, or radial artery are catheterized during endovascular therapy [ 9 , 17 ]. There are various agents used for embolization, such as metallic coils, glue, spheres, gel-foam particles, gelatin sponge particles, polymer microspheres, polyvinyl alcohol particles or a combination of these [ 1 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Bleeding occurring from advanced cervical cancer may appear in up to 70% of cases and is the immediate cause of death in 6% of patients with this kind of malignancy [ 15 , 16 ]. In case of emergency intractable bleeding, arterial embolization of branches of the internal iliac arteries represents a promising alternative [ 14 , 17 , 18 ]. Bilateral embolization should be performed due to collateral pelvic vasculature [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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(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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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“…There are multiple studies that have shown the role of selective pelvic-vessels embolization in cervical cancer ( Table 3 ). 4 , 9 , 11 - 17 …”

Section: Discussionmentioning

confidence: 99%

Emergency Embolization of Pelvic Vessels in Patients With Locally Advanced Cervical Cancer and Massive Vaginal Bleeding: A Case Series in a Latin American Oncological Center

Almeciga

Rodriguez

Beltrán

et al. 2020

JCO Global Oncology

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PURPOSE Locally advanced cervical cancer may present with uncontrollable vaginal bleeding in up to 70% of cases. Pelvic vessel embolization has been used as an urgent maneuver for achieving fast hemostatic control. This report describes outcomes of selective pelvic vessel embolization in patients with severe bleeding due to a locally advanced cervical cancer. METHODS In this retrospective study, technical aspects, clinical variables, and bleeding-related morbidity were described. The frequency of recurrent disease and the vital status at 1 year of follow-up were determined. Analysis was performed with statistical software R, version 3.6.2. The setting was Instituto Nacional de Cancerología- Bogotá, Colombia, between January 2009 and July 2017. RESULTS A total of 47 patients were included. Median age was 44 years (range, 26-70 years). The pre-embolization median hemoglobin level was 7.9 g/dL (range, 5.0-11.3 g/dL). Blood transfusions were administered to 41 women (87.2%). Bleeding control was achieved in 95.7% of cases in the first 24 hours after the embolization. There were no major complications. In 17 cases (36.2%), minor complications were reported; the most common was pelvic pain. In 17.1% of cases, a second embolization was required. After 12 months of follow-up, 27.7% of patients were alive without disease, 44.7% were alive with disease, and 25.5% of them have died of cervical cancer progression. CONCLUSION Selective pelvic vessel embolization is a useful alternative in patients with locally advanced cervical cancer and life-threatening bleeding. Its impact on recurrent disease and death due to oncologic cause is not clear.

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Transarterial Pelvic Artery Embolization in Vaginal Bleeding Due to Advanced Gynecological Malignancy: A Comprehensive Review

Kaur

Triveni²,

Chandrashekhara³

2022

Indian J Gynecol Oncolog

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The Belarus Experience of Pelvic Artery Embolisation in Patients with Advanced and Recurrent Cervical Cancer Presenting with Haemorrhage

Cited by 3 publications

References 9 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

Emergency Embolization of Pelvic Vessels in Patients With Locally Advanced Cervical Cancer and Massive Vaginal Bleeding: A Case Series in a Latin American Oncological Center

Transarterial Pelvic Artery Embolization in Vaginal Bleeding Due to Advanced Gynecological Malignancy: A Comprehensive Review

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