Uterine artery embolization: An underused method of controlling pelvic hemorrhage

Vedantham, Suresh; Goodwin, Scott C.; McLucas, Bruce; Mohr, Gregory

doi:10.1016/s0002-9378(97)70624-0

Cited by 370 publications

(208 citation statements)

References 31 publications

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“…However, we believe that the data presented here provide the first step in designing a clinical intervention for severe FGR, probably using minimally invasive X-ray-guided catheterization by the femoral artery to access the uteroplacental circulation. 38 The optimum method for delivering therapy, either intraor extraluminal, and the need for vessel occlusion are important factors to investigate. We plan further experiments to determine the safety and feasibility of this gene therapy approach to improving placental perfusion.…”

mentioning

confidence: 99%

Local delivery of VEGF adenovirus to the uterine artery increases vasorelaxation and uterine blood flow in the pregnant sheep

et al. 2008

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confidence: 99%

Local delivery of VEGF adenovirus to the uterine artery increases vasorelaxation and uterine blood flow in the pregnant sheep

et al. 2008

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“…Vedantham states that literature review and clinical experience suggest that embolization should be used before surgical treatment of nonmalignant pelvic bleed in many clinical situations including post-partum, post-cesarean and post-operative bleeding [8].…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm of Uterine Artery: A Rare Cause of Secondary Postpartum Hemorrhage

Chitra

Panicker

2011

J Obstet Gynecol India

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Objectives Secondary PPH has received little attention. In more than half of cases the etiology is not made out. Vascular abnormalities like pseudoaneurysm and AV malformation are rare but detectable and easily treatable. Methods This is an analysis of five women presenting with severe secondary PPH after the 3rd to 6th week of postpartum. All women were post LSCS with no identifiable cause and referred for further management. They were diagnosed to have pseudoaneurysm by angiography and uterine artery embolisation was done. Results Five women were analysed. Four of them had a pseudoaneurysm and were embolised one woman was hemodynamically unstable and hence taken up for hysterectomy. Conclusion Pseudoaneurysm is an important vascular abnormality especially following LSCS. Uterine artery embolisation is safe and reliable alternative technique and prevents a hysterectomy.

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“…The reported success rate of IIAL varies from 42 to 100 % [3], and it averts radical procedures like hysterectomy in substantial number of cases. It creates a relatively bloodless operative field for surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

Ligating Internal Iliac Artery: Success beyond Hesitation

Singh

Kishore

Saxena

2016

J Obstet Gynecol India

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Aim To study the outcomes, benefits and complications of internal iliac artery ligation in both obstetric and gynecological cases.Objective To study the outcomes, effectiveness and complications of internal iliac artery ligation (IIAL). Method This is an analytical longitudinal study done among women who have undergone internal iliac artery ligation in Dr. BRAMH a tertiary referral center from July 2013 to June 2015. Follow-up was done through color Doppler analysis of pelvic arteries before discharge, after 6 weeks and after 6 months. Result The efficacy of IIAL was 96.87 %. The mean shock index was 0.94 ± 0.26. Sixty-four women underwent IIAL out of which placenta previa (21.8 %) was the major indication. There were four maternal deaths. There were no intraoperative or ischemic complications. The greater the time interval between onset of hemorrhage and IIAL, the graver the outcome. For all women in whom uterus could be salvaged, resumption of menstrual cycles was seen within 6 months of IIAL. There was a significant decrease in the RI and PI of uterine arteries. In the ovarian arteries, there was a significant increase in RI and no significant change in PI initially. Flow in distal part of ligated internal iliac arteries could be detected in 54 (90 %) women out of 60 after 6 months of ligation of internal iliac arteries. Conclusion IIAL is an effective life-saving method to control obstetric and gynecological hemorrhage, and a hysterectomy can often be avoided. Early resort to IIAL is vital for improving the patient outcome. Uterine perfusion is well maintained, while there may be a decrease in ovarian perfusion. Resumption of menstrual cycles and presence of distal flow in internal iliac artery within 6 months suggest the preservation of future fertility; in order to better understand the impact of IIAL on ovarian functions and future fertility, larger studies with longer follow-up periods need to be conducted.

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Uterine artery embolization: An underused method of controlling pelvic hemorrhage

Cited by 370 publications

References 31 publications

Local delivery of VEGF adenovirus to the uterine artery increases vasorelaxation and uterine blood flow in the pregnant sheep

Local delivery of VEGF adenovirus to the uterine artery increases vasorelaxation and uterine blood flow in the pregnant sheep

Pseudoaneurysm of Uterine Artery: A Rare Cause of Secondary Postpartum Hemorrhage

Ligating Internal Iliac Artery: Success beyond Hesitation

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