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Journals / Journal of the Turkish-German Gynecological Association / 2007 / Cilt: 8 - Sayı: 3

Endovascular embolization in management of vaginal bleeding

Vajinal kanamaların endovasküler embolizasyonla tedavisi

Fürüzan NUMAN
Murat CANTAŞDEMİR
Hasanefendioğlu Aylin BAYRAK
Ahnet BAŞ
Pages
315–320
Publication Date
2022-11-05
DOI
—
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Because of various factors (lower mortality and morbidity rates, preservation of surgical options even after unsuccesful embolization), the endovascular embolization should be kept in mind as a first treatment modality

📌 3 Key Takeaways

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Objective & Hypothesis:PURPOSE: To investigate results and effectiveness of endovascular embolization in treatment of massive or intractable vaginal bleeding.
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Key Findings & Data:Material-Metods: Between 1991-2004, 9 patients with vaginal bleeding ranging in age from 28 to 53 years (mean; 45.3 years) were treated with endovascular embolization therapy.
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Conclusion & Impact:Because of various factors (lower mortality and morbidity rates, preservation of surgical options even after unsuccesful embolization), the endovascular embolization should be kept in mind as a first treatment modality
🔬Design:Research Article
📍Scope:2004 Verileri
⚙️Variables:Domain Parameters

Abstract

PURPOSE: To investigate results and effectiveness of endovascular embolization in treatment of massive or intractable vaginal bleeding. Material-Metods: Between 1991-2004, 9 patients with vaginal bleeding ranging in age from 28 to 53 years (mean; 45.3 years) were treated with endovascular embolization therapy. The causes of massive vaginal bleeding were; gynecological malignancy in 8 cases, and arterial pseudoaneurysm formation following postpartum subtotal hysterectomy in 1 case. We used polivynil alcohol (PVA) particles in cases of gynecological malignancies, and Gelfoam in the postpartum case as embolizing agents. The results were retrospectively analysed. RESULTS: Diagnostic angiograms demonstrated tumoral blush in all cases with pelvic malignancies fed by the branches of both internal iliac artery. In obstetric case, a pseudoaneurysm at lateral wall of the cervix and the vaginal cuff, which was the source of bleeding. The embolization procedures were technically successful and vaginal bleeding was controlled after embolization in all cases. In two cases, with gynecological malignancy, 20% and 30% residual tumoral blush were seen, respectively. The latter case rebleeded after 4 months, and re-embolization was performed successfully. In all other cases, there were no recurrent vaginal bleeding. CONCLUSION: The endovascular embolization is a safe and effective treatment in massive or intractable vaginal bleeding. Because of various factors (lower mortality and morbidity rates, preservation of surgical options even after unsuccesful embolization), the endovascular embolization should be kept in mind as a first treatment modality

Özet

AMAÇ: Durdurulamayan ya da masif vajinal kanamaların endovasküler embolizasyon ile tedavi sonuçları ve etkinliğini sunmak. GEREÇ-YÖNTEM: 1991-2004 yılları arasında, yaşları 28-53 arasında (ortalama; 45.3 yıl) olan 9 olguya endovasküler embolizasyon uygulandı. 8 olguda etyoloji jinekolojik malignite, 1 olguda ise postpartum subtotal histerektomiye sekonder gelişen psödoanevrizma idi. Malignite nedeni ile tedavi uygulanan olgularda embolizan ajan olarak polivinil alkol (PVA) partikülleri, postpartum vajinal kanamalı olguda ise Gelfoam kullanıldı. Bulgular retrospektif olarak değerlendirildi. BULGULAR: Tanısal anjiogramlarda, pelvik maligniteli tüm olgularda her iki internal iliak arter dallarıyla beslenen tümöral boyanma izlendi. Obstetrik olguda ise kanama odağı olarak serviks sağ duvarı ve vajinal kubbede psödoanevrizma tespit edildi. Tüm olgularda embolizasyon başarı ile gerçekleştirildi ve vajinal kanama tamamen kontrol altına alındı. Jinekolojik maligniteli 2 olguda sırasıyla; % 20 ve % 30 rezidü tümöral boyanma izlendi. % 30 rezidüsü olan olguda 4 ay sonra rekürren kanama izlendi ve 2.seans embolizasyon yapıldı. Diğer olgularda rekürren kanama saptanmadı. SONUÇ: Endovasküler embolizasyon durdurulamayan ya da masif vajinal kanamalarda güvenli ve etkili tedavi yöntemidir. Çeşitli avantajları nedeniyle (düşük mortalite ve morbidite oranları, başarısızlık durumunda cerrahi tedavi şansının devam etmesi gibi) vajinal kanamalı olgularda birinci seçenek tedavi yöntemi olarak akılda tutulmalıdır

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Cite This Article

NUMAN, F., CANTAŞDEMİR, M., BAYRAK, H. A., BAŞ, A. (2022). Endovascular embolization in management of vaginal bleeding. Journal of the Turkish-German Gynecological Association, Cilt: 8 - Sayı: 3, 315–320. https://ajindex.com/articles/652627

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