Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding

CVIR Endovascular

Mamiko Okamoto¹  Yasushi Kawano¹  Norio Hongo²  Satomi Ide²  Miyuki Maruno²  Yoshiki Asayama²  Hiro Kiyosue²  Ryuichi Shimada²  Kohei Tokuyama²  Ryo Takaji² 

[1] Department of Obstetrics and Gynecology, Oita University Faculty of Medicine, 879-5593, Yufu, Oita, Japan;Departments of Radiology, Oita University Faculty of Medicine, 879-5593, Yufu City, Oita, Japan;

关键词: Retained placenta;    Angiography;    Transarterial embolization;   

DOI  :  10.1186/s42155-021-00265-z

来源: Springer

【 摘 要 】

ObjectivesTo clarify characteristic angiographic features and clinical efficacy of selective transarterial embolization (TAE) of retained placenta with abnormal vaginal bleeding.MethodsThe study cohort comprised 22 patients (mean age, 33.5 years; range, 22–24 years) who underwent selective TAE for retained placenta with abnormal bleeding between January 2018 and December 2020 at our institution. Angiographic images were reviewed by two certified radiologists with consensus. Medical records were reviewed to evaluate the efficacy of TAE. Angiographic features of retained placenta, technical success (disappearance of abnormal findings on angiography), complications, clinical outcomes (hemostatic effects and recurrent bleeding) were evaluated.ResultsPelvic angiography showed a dilated vascular channel mimicking arteriovenous fistulas or an aneurysm contiguous with dilated uterine arteries in the mid-arterial–capillary phase in 20 patients; it showed contrast brush in the remaining two patients. TAE technical success was achieved in all patients. No major complications were observed in any patients. Fifteen patients were followed up with expectant management after TAE; all but one patient showed no re-bleeding during the follow-up period (mean follow-up interval, 3.4 months; range, 1–17 months). One patient showed minor rebleeding, which resolved spontaneously. Seven patients underwent scheduled hysteroscopic resection within 1 week after TAE, and no excessive bleeding was observed during or after the surgical procedure in all seven patients.ConclusionsThe characteristic angiographic feature of retained placenta is “dilated vascular channel that mimic low flow AVM.” TAE is a safe and effective treatment to manage retained placenta with abnormal bleeding.

【 授权许可】

CC BY