Download PDF
CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2023; 07(02): 113-117
DOI: 10.1055/s-0042-1751250
Case Series

Endovascular Embolisation Using N-Butyl-2-Cyanoacrylate: An Effective Treatment Option for Uterine Artery Pseudoaneurysm in Postpartum Hemorrhage

Venkatesh Pothula 
1   Department of Neuro & Interventional Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
Jagadeesan Dhanasekaran 
1   Department of Neuro & Interventional Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
Jyothsna Nekkala 
2   Department of Obstetrics and Gynecology, Chennai Fertility Centre, Chennai, Tamil Nadu, India
,
Sabarish Sekar 
1   Department of Neuro & Interventional Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
Santhosh Joseph 
1   Department of Neuro & Interventional Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

In this case series, we evaluated the efficacy and safety of uterine artery embolization (UAE) using N-butyl- 2-cyanoacrylate (NBCA)/glue for the treatment of uterine artery pseudoaneurysm (UAP). Here, we report 8 patients with uterine artery pseudoaneurysm, who underwent UAE using NBCA/glue. Angiograms and medical records were retrospectively analyzed to determine the technical success, clinical success, complications, average procedure time, the average duration of hospital stay after UAE. All patients were presented with secondary postpartum hemorrhage with hemodynamic instability. The technical and clinical success rates were 100%, respectively. The average procedure time was 21minutes and the average duration of hospital stay was 2.2 days. We did not encounter any major complications. Two patients following UAE were naturally conceived and delivered by repeat LSCS. UAE using NBCA/glue is a safe and effective treatment option for UAP in both hemodynamically stable and unstable patients.

Keywords

uterine artery embolization - NBCA - uterine artery pseudoaneurysm

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards


Informed Consent

Informed consent was obtained from all individual participants included in the study.




Publication History

Article published online:
11 July 2022

© 2022. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Say L, Chou D, Gemmill A. et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health 2014; 2 (06) e323-e333 DOI: 10.1016/S2214-109X(14)70227-X.
    CrossrefPubMedGoogle Scholar
  • 2 Sharma N, Ganesh D, Devi L, Srinivasan J, Ranga U. Prompt diagnosis and treatment of uterine arcuate artery pseudoaneurysm: a case report and review of literature. J Clin Diagn Res 2013; 7 (10) 2303-2306
    CrossrefPubMedGoogle Scholar
  • 3 Matsubara S, Sato T, Nakata M. Vaginal artery embolization with a permanent embolic agent for intractable postpartum hemorrhage. J Obstet Gynaecol Res 2011; 37 (04) 377-378
    CrossrefPubMedGoogle Scholar
  • 4 Kim GM, Yoon CJ, Seong NJ, Kang SG, Kim YJ. Postpartum haemorrhage from ruptured pseudoaneurysm: efficacy of transcatheter arterial embolisation using N-butyl-2-cyanoacrylate. Eur Radiol 2013; 23 (08) 2344-2349
    CrossrefPubMedGoogle Scholar
  • 5 Pelage JP, Soyer P, Repiquet D. et al. Secondary postpartum hemorrhage: treatment with selective arterial embolization. Radiology 1999; 212 (02) 385-389
    CrossrefPubMedGoogle Scholar
  • 6 Kim YA, Han YH, Jun KC, Jeon MK, Lee ES. Uterine artery pseudoaneurysm manifesting delayed postabortal bleeding. Fertil Steril 2008; 90 (03) 849.e11-849.e14
    CrossrefPubMedGoogle Scholar
  • 7 Kovo M, Behar DJ, Friedman V, Malinger G. Pelvic arterial pseudoaneurysm-a rare complication of Cesarean section: diagnosis and novel treatment. Ultrasound Obstet Gynecol 2007; 30 (05) 783-785
    CrossrefPubMedGoogle Scholar
  • 8 Boi L, Savastano S, Beghetto M, Dall'Acqua J, Montenegro GM. Embolization of iatrogenic uterine pseudoaneurysm. Gynecol Minim Invasive Ther 2017; 6 (02) 85-88
    CrossrefPubMedGoogle Scholar
  • 9 Soyer P, Fargeaudou Y, Morel O, Boudiaf M, Le Dref O, Rymer R. Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization. Eur Radiol 2008; 18 (06) 1181-1187
    CrossrefPubMedGoogle Scholar
  • 10 Kwon Y, So YH, Kim BJ, Kim SM, Choi YH, Moon MH. Uterine artery embolization in patients with postpartum hemorrhage: clinical efficacy and safety of treatment with N-butyl-2-cyanoacrylate. J Korean Soc Radiol 2019; 80 (01) 88-97
    CrossrefPubMedGoogle Scholar