Transcatheter Arterial Embolization for Hemorrhage after Gynecologic Hysterectomy: A Multicenter STU

Introduction: Transcatheter arterial embolization (TAE) is not common for hemorrhagic complications after gynecologic hysterectomy retrospective, multicenter study, 11 patients who underwent TAE for hemorrhage after gynecologic hysterectomy between 2004 and 2020.

Method(s): Median interval between surgery and angiography was 1 day (range = 0–82 days). Hemodynamic instability and massive transfusion were present in 6 (54.5%) and 4 (36.4%) patients, respectively. CT scans (n = 7) showed contrast extravasation (n = 5), pseudoaneurysm (n = 1), or both (n = 1). On angiography, the bleeding arteries were the anterior division branches of the internal iliac artery (IIA) (n = 6), posterior division branch (lateral sacral artery, n = 1), and inferior epigastric artery.

Result(s): (n = 1) in eight patients with active bleeding. Technical and clinical success rates were 100 and 90.9%, respectively. In one patient, active bleeding focus was successfully embolized on angiography, but surgical hemostasis was performed for suspected bleeding on exploratory laparotomy.

Conclusion(s): TAE is effective and safe for hemorrhage after hysterectomy for gynecologic diseases. Angiographic findings are primarily active bleeding, but angiographic staining is not uncommon.

Publication History

Article published online:
09 February 2023