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Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations.
Cardiovasc Intervent Radiol. 2016 Aug; 39(8):1170-6.CI

Abstract

PURPOSE

The purpose of the study was to evaluate the technique and outcomes of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) for the treatment of acquired uterine arteriovenous malformations (AVMs).

MATERIALS AND METHODS

A retrospective review identified five women treated for suspected acquired uterine AVMs with TAE at our institution. Four women (80 %) presented with heavy or intermittent vaginal bleeding after obstetric manipulation. One woman (20 %) was treated for an incidental AVM discovered on ultrasound after an uncomplicated cesarean section. Three women underwent one embolization procedure and two women required two procedures. Embolization material included NBCA in six procedures (80 %) and gelatin sponge in one procedure (20 %).

RESULTS

Embolization resulted in angiographic stasis of flow in all seven procedures. Four women (80 %) presented with vaginal bleeding which was improved after treatment. One woman returned 24 days after unilateral embolization with recurrent bleeding, which resolved after retreatment. One woman underwent two treatments for an asymptomatic lesion identified on ultrasound. There were no major complications. Three women (60 %) experienced mild postembolization pelvic pain that was controlled with non-steroidal anti-inflammatory drugs. Three women (60 %) had pregnancies and deliveries after embolization.

CONCLUSIONS

TAE is a safe alternative to surgical therapy for acquired uterine AVMs with the potential to maintain fertility. Experience from this case series suggests that NBCA provides predictable and effective occlusion.

Authors+Show Affiliations

Department of Radiology, University of California, San Diego, 200 West Arbor Drive, San Diego, CA, 92103-8756, USA. apicel@ucsd.edu.Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.Department of Radiology, University of California, San Diego, 200 West Arbor Drive, San Diego, CA, 92103-8756, USA.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

27021069

Citation

Picel, Andrew C., et al. "Transcatheter Arterial Embolization With n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations." Cardiovascular and Interventional Radiology, vol. 39, no. 8, 2016, pp. 1170-6.
Picel AC, Koo SJ, Roberts AC. Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations. Cardiovasc Intervent Radiol. 2016;39(8):1170-6.
Picel, A. C., Koo, S. J., & Roberts, A. C. (2016). Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations. Cardiovascular and Interventional Radiology, 39(8), 1170-6. https://doi.org/10.1007/s00270-016-1328-z
Picel AC, Koo SJ, Roberts AC. Transcatheter Arterial Embolization With n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations. Cardiovasc Intervent Radiol. 2016;39(8):1170-6. PubMed PMID: 27021069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations. AU - Picel,Andrew C, AU - Koo,Sonya J, AU - Roberts,Anne C, Y1 - 2016/03/28/ PY - 2015/11/20/received PY - 2016/03/13/accepted PY - 2016/3/30/entrez PY - 2016/3/30/pubmed PY - 2017/7/14/medline KW - Transcatheter arterial embolization KW - Uterine arteriovenous fistula KW - Uterine arteriovenous malformation KW - Uterine vascular malformation KW - n-Butyl cyanoacrylate SP - 1170 EP - 6 JF - Cardiovascular and interventional radiology JO - Cardiovasc Intervent Radiol VL - 39 IS - 8 N2 - PURPOSE: The purpose of the study was to evaluate the technique and outcomes of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) for the treatment of acquired uterine arteriovenous malformations (AVMs). MATERIALS AND METHODS: A retrospective review identified five women treated for suspected acquired uterine AVMs with TAE at our institution. Four women (80 %) presented with heavy or intermittent vaginal bleeding after obstetric manipulation. One woman (20 %) was treated for an incidental AVM discovered on ultrasound after an uncomplicated cesarean section. Three women underwent one embolization procedure and two women required two procedures. Embolization material included NBCA in six procedures (80 %) and gelatin sponge in one procedure (20 %). RESULTS: Embolization resulted in angiographic stasis of flow in all seven procedures. Four women (80 %) presented with vaginal bleeding which was improved after treatment. One woman returned 24 days after unilateral embolization with recurrent bleeding, which resolved after retreatment. One woman underwent two treatments for an asymptomatic lesion identified on ultrasound. There were no major complications. Three women (60 %) experienced mild postembolization pelvic pain that was controlled with non-steroidal anti-inflammatory drugs. Three women (60 %) had pregnancies and deliveries after embolization. CONCLUSIONS: TAE is a safe alternative to surgical therapy for acquired uterine AVMs with the potential to maintain fertility. Experience from this case series suggests that NBCA provides predictable and effective occlusion. SN - 1432-086X UR - https://www.unboundmedicine.com/medline/citation/27021069/Transcatheter_Arterial_Embolization_with_n_Butyl_Cyanoacrylate_for_the_Treatment_of_Acquired_Uterine_Vascular_Malformations_ L2 - https://dx.doi.org/10.1007/s00270-016-1328-z DB - PRIME DP - Unbound Medicine ER -