Uterine Artery Embolization in Patients with Postpartum Hemorrhage: Clinical Efficacy and Safety of Treatment with N-Butyl-2-Cyanoacrylate
권요한, 소영호, 김병재, 김선민, 최용호, 문민환,
소속 상세정보
권요한 ( Kwon Yo-Han )
Seoul National University Hospital Department of Radiology
소영호 ( So Young-Ho )
Seoul Metropolitan Government Boramae Medical Center Department of Radiology
김병재 ( Kim Byoung-Jae )
Seoul Metropolitan Government Boramae Medical Center Department of Obstetrics and Gynecology
김선민 ( Kim Sun-Min )
Seoul Metropolitan Government Boramae Medical Center Department of Obstetrics and Gynecology
최용호 ( Choi Young-Ho )
Seoul Metropolitan Government Boramae Medical Center Department of Radiology
문민환 ( Moon Min-Hoan )
Seoul Metropolitan Government Boramae Medical Center Department of Radiology
Abstract
Purpose: To evaluate the clinical efficacy and safety of uterine artery embolization (UAE) using N-butyl-2-cyanoacrylate (NBCA) in patients with postpartum hemorrhage (PPH).
Materials and Methods: From February 2010 to May 2018, 14 patients (age: 28?39 years; mean: 33 years) underwent UAE using NBCA among 82 patients with PPH. Medical records were retrospectively reviewed to evaluate the patients characteristics, cause of PPH, embolization procedure, and outcomes.
Results: Angiograms revealed extravasation (n = 10) or pseudoaneurysm (n = 4) in all patients. The causes of PPH were hysterotomy or hysterectomy related arterial injury (n = 11), cervical laceration (n = 2), and abnormal placentation (n = 1). UAE was performed with NBCA in all patients. Additional UAE with gelatin sponge particles was performed in two patients. Additional non-uterine artery embolization was performed in three patients. Coagulopathy was found in five (35.7%) patients. The technical and clinical success rates were 92.9% and 85.7%, respectively. One patient died from multi-organ failure eight days after UAE. One patient with abnormal placentation had pelvic organ ischemia due to multiple pelvic artery embolization.
Conclusion: UAE using NBCA is safe and effective for the patients with PPH showing extravasation or pseudoaneurysm.
키워드
Embolization, Therapeutic; Postpartum Hemorrhage; Cyanoacrylates; Uterine Artery; Aneurysm, False
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