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90008772

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Efficacy of superselective transcatheter arterial embolization for intractable postpartum hemorrhage due to genital tract trauma after vaginal delivery

A3021 / A1460 / A1392 / / A2559 / A1505 / A1469 / A1440 / A0041 / A0768 / A2302

Sasaki, Koji
Okada, Takuya
Yamaguchi, Masato
Ahmed, Mostafa
Gentsu, Tomoyuki
Ueshima, Eisuke
Sofue, Keitaro
Tanimura, Kenji
Yamada, Hideto
Sugimoto, Koji
Murakami, Takamichi

佐々木, 康二 / 岡田, 卓也 / 山口, 雅人 / / 元津, 倫幸 / 上嶋, 英介 / 祖父江, 慶太郎 / 谷村, 憲司 / 山田, 秀人 / 杉本, 幸司 / 村上, 卓道

28(6)

1127-1133

Springer

2021-12

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

2021-11-11

14381435

eng

1000010815989 / 1000080514786 / 1000010457096 / / 1000070836379 / 1000040645561 / 1000090622027 / 1000080593988 / 1000040220397 / 1000090314476 / 1000020252653

Purpose To evaluate the efficacy of superselective transcatheter arterial embolization (TAE) for intractable postpartum hemorrhage (PPH) due to genital tract trauma (GTT) after vaginal delivery. Methods We evaluated 27 patients who underwent TAE for intractable PPH due to GTT after vaginal delivery at our institution between January 2008 and December 2020. Patients were divided into two groups according to TAE procedure; TAE performed as close as possible to the bleeding point, at least more peripherally than the second branch of the anterior division of the internal iliac artery, was defined as superselective TAE (S-TAE). TAE performed from the proximal segment of the internal iliac artery was defined as proximal TAE (P-TAE). Patient characteristics, pre-procedural contrast-enhanced computed tomography (CE-CT), procedure details, technical/clinical success, and complications were evaluated separately for the S-TAE and P-TAE groups. Results The combined technical/clinical success rate was 92%. No major procedure-related complications were seen (mean follow-up: 6.12 ± 3.93 days). The combined technical/clinical success rate of S-TAE was 100% and of P-TAE was 67% (p = 0.04). S-TAE was performed more frequently in patients with pre-procedural CE-CT (p = 0.01) and use of permanent embolic materials (p = 0.003). Conclusion S-TAE is safe and effective for intractable PPH due to GTT. Pre-procedural CE-CT may be useful for detecting the culprit artery and be helpful in performing S-TAE.

Selective transcatheter arterial embolization / Postpartum hemorrhage / Genital tract trauma / Pre-procedural contrast-enhanced computed tomography

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2021-11-11