Korean J Radiol.
2014 Jun;15(3):356-363. 10.3348/kjr.2014.15.3.356.
Post-Operative Hemorrhage after Myomectomy: Safety and Efficacy of Transcatheter Uterine Artery Embolization
- Affiliations
-
- 1Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong.
- 2Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea. jhshin@amc.seoul.kr
- 3Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 463-707, Korea.
- KMID: 2078645
- DOI: http://doi.org/10.3348/kjr.2014.15.3.356
Abstract
OBJECTIVE
To evaluate the safety and clinical efficacy of transcatheter uterine artery embolization (UAE) for post-myomectomy hemorrhage.
MATERIALS AND METHODS
We identified eight female patients (age ranged from 29 to 51 years and with a median age of 37) in two regional hospitals who suffered from post-myomectomy hemorrhage requiring UAE during the time period from 2004 to 2012. A retrospective review of the patients' clinical data, uterine artery angiographic findings, embolization details, and clinical outcomes was conducted.
RESULTS
The pelvic angiography findings were as follows: hypervascular staining without bleeding focus (n = 5); active contrast extravasation from the uterine artery (n = 2); and pseudoaneurysm in the uterus (n = 1). Gelatin sponge particle was used in bilateral uterine arteries of all eight patients, acting as an empirical or therapeutic embolization agent for the various angiographic findings. N-butyl-2-cyanoacrylate was administered to the target bleeding uterine arteries in the two patients with active contrast extravasation. Technical and clinical success were achieved in all patients (100%) with bleeding cessation and no further related surgical intervention or embolization procedure was required for hemorrhage control. Uterine artery dissection occurred in one patient as a minor complication. Normal menstrual cycles were restored in all patients.
CONCLUSION
Uterine artery embolization is a safe, minimally invasive, and effective management option for controlling post-myomectomy hemorrhage without the need for hysterectomy.
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