Post-Operative Hemorrhage after Myomectomy: Safety and Efficacy of Transcatheter Uterine Artery Embolization.
10.3348/kjr.2014.15.3.356
- Author:
Alvin Yu Hon WAN
1
;
Ji Hoon SHIN
;
Hyun Ki YOON
;
Gi Young KO
;
Sangik PARK
;
Nak Jong SEONG
;
Chang Jin YOON
Author Information
1. Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong.
- Publication Type:Original Article ; Evaluation Studies
- Keywords:
Uterine artery embolization;
Digital subtraction angiography;
Uterine myomectomy;
Uterine myoma
- MeSH:
Adult;
Female;
Humans;
Hysterectomy;
Leiomyoma/blood supply/*surgery;
Middle Aged;
Postoperative Hemorrhage/*therapy;
Retrospective Studies;
Treatment Outcome;
Uterine Artery Embolization/adverse effects/*methods;
Uterine Neoplasms/blood supply/*surgery;
Uterus/blood supply/surgery
- From:Korean Journal of Radiology
2014;15(3):356-363
- CountryRepublic of Korea
- Language:English
-
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.
