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Transvaginal oocyte retrieval complicated by life-threatening obturator artery haemorrhage and managed by a vessel-preserving technique.

Bolster F, Mocanu E, Geoghegan T, Lawler L - Ulster Med J (2014)

Bottom Line: Four days following the procedure she presented with life threatening haemorrhagic shock.She underwent surgical laparotomy followed by CT and selective angiography, which demonstrated haemorrhage from a pseudoaneurysm of the obturator artery.The haemorrhage was successfully managed endovascularly with a vessel preserving covered stent.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Mater Misericordiae University Hospital Dublin, Ireland.

ABSTRACT
We report the case of a 36-year-old woman with secondary infertility who underwent routine transvaginal oocyte retrieval as part of IVF treatment. Four days following the procedure she presented with life threatening haemorrhagic shock. She underwent surgical laparotomy followed by CT and selective angiography, which demonstrated haemorrhage from a pseudoaneurysm of the obturator artery. The haemorrhage was successfully managed endovascularly with a vessel preserving covered stent.

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Up and over selective cannulation of the right internal iliac artery was performed and demonstrated a 2cm saccular obturator artery pseudoaneurysm (white arrows).
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fig03: Up and over selective cannulation of the right internal iliac artery was performed and demonstrated a 2cm saccular obturator artery pseudoaneurysm (white arrows).

Mentions: A retrograde 5Fr sheath was inserted into the left common femoral artery under ultrasound guidance. Up and over selective cannulation of the right internal iliac artery was performed and demonstrated a relatively large obturator artery pseudoaneurysm (see Fig 3). The pseudoaneurysm neck was crossed with a combination microcatheter .014 wire. The bleeding site was treated with a 3mm x10mm coronary artery covered stent (Jo Stent Graftmaster) (see Fig 4). Subsequent DSA showed good stent position and cessation of extravasation of contrast (Fig. 5). The patient made a rapid full recovery and a follow up CTA performed the next day confirmed good stent positioning with no extravasation of contrast into the treated pseudoaneurysm.


Transvaginal oocyte retrieval complicated by life-threatening obturator artery haemorrhage and managed by a vessel-preserving technique.

Bolster F, Mocanu E, Geoghegan T, Lawler L - Ulster Med J (2014)

Up and over selective cannulation of the right internal iliac artery was performed and demonstrated a 2cm saccular obturator artery pseudoaneurysm (white arrows).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4255834&req=5

fig03: Up and over selective cannulation of the right internal iliac artery was performed and demonstrated a 2cm saccular obturator artery pseudoaneurysm (white arrows).
Mentions: A retrograde 5Fr sheath was inserted into the left common femoral artery under ultrasound guidance. Up and over selective cannulation of the right internal iliac artery was performed and demonstrated a relatively large obturator artery pseudoaneurysm (see Fig 3). The pseudoaneurysm neck was crossed with a combination microcatheter .014 wire. The bleeding site was treated with a 3mm x10mm coronary artery covered stent (Jo Stent Graftmaster) (see Fig 4). Subsequent DSA showed good stent position and cessation of extravasation of contrast (Fig. 5). The patient made a rapid full recovery and a follow up CTA performed the next day confirmed good stent positioning with no extravasation of contrast into the treated pseudoaneurysm.

Bottom Line: Four days following the procedure she presented with life threatening haemorrhagic shock.She underwent surgical laparotomy followed by CT and selective angiography, which demonstrated haemorrhage from a pseudoaneurysm of the obturator artery.The haemorrhage was successfully managed endovascularly with a vessel preserving covered stent.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Mater Misericordiae University Hospital Dublin, Ireland.

ABSTRACT
We report the case of a 36-year-old woman with secondary infertility who underwent routine transvaginal oocyte retrieval as part of IVF treatment. Four days following the procedure she presented with life threatening haemorrhagic shock. She underwent surgical laparotomy followed by CT and selective angiography, which demonstrated haemorrhage from a pseudoaneurysm of the obturator artery. The haemorrhage was successfully managed endovascularly with a vessel preserving covered stent.

Show MeSH
Related in: MedlinePlus