Document Detail

Embolization of bleeding residual uterine vascular malformations in patients with treated gestational trophoblastic tumors.
MedLine Citation:
PMID:  11867779     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To retrospectively evaluate embolotherapy of bleeding residual uterine vascular malformations in patients with gestational trophoblastic tumors. MATERIALS AND METHODS: Fourteen patients were treated over the past 20 years. Embolizations were performed with a common femoral artery approach. Duplex ultrasonography was performed before and after embolization to document the uterine vascularity. The technique and materials used for each embolization, control of hemorrhage, need for repeat embolization, complications, and outcome of subsequent pregnancies were assessed. RESULTS: Hemorrhage was controlled in 11 of the 14 patients; two patients required hysterectomy and one required uterine artery ligation for failure to control hemorrhage after initial embolization. Six patients required repeat embolization for recurrence of bleeding. Therapeutic benefit and success were associated with the ability to selectively embolize the uterine artery and to achieve a greater than 80% reduction in vascular malformation size. Pulsatility indexes of the uterine arteries and endometrial encroachment were not predictive of recurrent hemorrhage. Two patients delivered a total of three full-term infants, one patient experienced a miscarriage, and another experienced a termination of pregnancy following embolotherapy. Pain requiring opiate analgesia was a frequent complication of treatment. CONCLUSION: Selective uterine artery embolization is a safe and effective treatment for severe bleeding from residual uterine vascular malformations in patients with treated gestational trophoblastic tumors.
Adrian K P Lim; Roshan Agarwal; Michael J Seckl; Edward S Newlands; Nigel K Barrett; Adam W M Mitchell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  222     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-02-27     Completed Date:  2002-05-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  640-4     Citation Subset:  AIM; IM    
Department of Imaging, Hammersmith Hospitals NHS Trust, Charing Cross Hospital, Fulham Palace Rd, London W6 8RF, England.
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MeSH Terms
Angiography, Digital Subtraction
Arteriovenous Malformations / complications,  diagnosis,  therapy*
Embolization, Therapeutic*
Pulsatile Flow
Retrospective Studies
Trophoblastic Neoplasms / complications*,  therapy
Ultrasonography, Doppler
Uterine Hemorrhage / etiology,  therapy*
Uterus / blood supply*

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