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KMID : 0880420140150030356
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Korean Journal of Radiology
2014 Volume.15 No. 3 p.356 ~ p.363
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Post-Operative Hemorrhage after Myomectomy: Safety and Efficacy of Transcatheter Uterine Artery Embolization
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Wan Alvin Yu-Hon
Shin Ji-Hoon
Yoon Hyun-Ki
Ko Gi-Young
Park Sang-Ik
Seong Nak-Jong
Yoon Chang-Jin
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Abstract
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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.
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KEYWORD
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Uterine artery embolization, Digital subtraction angiography, Uterine myomectomy, Uterine myoma
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