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KMID : 1103720190800010088
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Journal of the Korean Society of Radiology
2019 Volume.80 No. 1 p.88 ~ p.97
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Uterine Artery Embolization in Patients with Postpartum Hemorrhage: Clinical Efficacy and Safety of Treatment with N-Butyl-2-Cyanoacrylate
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Kwon Yo-Han
So Young-Ho
Kim Byoung-Jae
Kim Sun-Min
Choi Young-Ho
Moon Min-Hoan
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Abstract
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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.
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KEYWORD
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Embolization, Therapeutic, Postpartum Hemorrhage, Cyanoacrylates, Uterine Artery, Aneurysm, False
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