Limits...
Successful Transarterial Embolization of Uterine Arteriovenous Malformation: Report of Three Cases.

Chen LK, Yang BL, Chen KC, Tsai YL - Iran J Radiol (2016)

Bottom Line: We describe three childbearing-age females, who had abdominal pain and heavy vaginal bleeding, and were diagnosed as uterine AVM by color Doppler and angiography.The patients received successful superselective transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA).Three years after treatment, one of them was admitted to our hospital for vaginal delivery at 39 weeks of gestation, and the baby was healthy.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, National Taiwan University, Taipei, Taiwan.

ABSTRACT
Uterine arteriovenous malformations (AVMs) are relatively rare disorders that can cause life-threatening vaginal bleeding. We describe three childbearing-age females, who had abdominal pain and heavy vaginal bleeding, and were diagnosed as uterine AVM by color Doppler and angiography. The patients received successful superselective transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA). Three years after treatment, one of them was admitted to our hospital for vaginal delivery at 39 weeks of gestation, and the baby was healthy.

No MeSH data available.


Related in: MedlinePlus

A 38-year-old female with hypermenorrhea and intermittent severe abdominal pain for 12 days. A, Transvaginal gray-scale ultrasonography of the uterus shows hypo-echoic cyst-like lesions. B, The color Doppler ultrasonography demonstrates a hypervascular lesion, 2.7 × 2.4 × 2.1 cm with multidirectional turbulent flow at the body of the uterus. The main lesion is in the myometrium. C, Spectral Doppler ultrasonography shows low resistance index of 0.4. D, Angiography shows vascular tangles from the branches of the bilateral internal iliac arteries. E, Bilateral superselective embolization of the uterine arteries was done smoothly. F, The follow-up color Doppler ultrasonography shows a smaller lesion, 2.0 × 1.3 cm with minimal vascularity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4835739&req=5

fig23434: A 38-year-old female with hypermenorrhea and intermittent severe abdominal pain for 12 days. A, Transvaginal gray-scale ultrasonography of the uterus shows hypo-echoic cyst-like lesions. B, The color Doppler ultrasonography demonstrates a hypervascular lesion, 2.7 × 2.4 × 2.1 cm with multidirectional turbulent flow at the body of the uterus. The main lesion is in the myometrium. C, Spectral Doppler ultrasonography shows low resistance index of 0.4. D, Angiography shows vascular tangles from the branches of the bilateral internal iliac arteries. E, Bilateral superselective embolization of the uterine arteries was done smoothly. F, The follow-up color Doppler ultrasonography shows a smaller lesion, 2.0 × 1.3 cm with minimal vascularity.

Mentions: A 38-year-old female, G3P0AA3, with a history of regular 30-day menstrual intervals and 4 - 5 days duration of flow visited our outpatient department with the chief complaint of hypermenorrhea and intermittent severe abdominal pain for 12 days. She was in her usual healthy status until 12 days before when she used a massage machine on her belly to relieve constipation. Then she noted intermittent, severe, and dull lower-abdominal pain accompanied by nausea. The next day the vaginal bleeding started, which she thought was normal menses. Over the following 10 days, she found the pain diffused progressively; there was neither relief nor aggravating factor. The vaginal bleeding was persistent with blood clotting. She had no fever, dysuria, urinary frequency, or purulent vaginal discharge. According to the medical record at outpatient department, her temperature was 36.8°C, heart rate was 84 times/minute, respiratory rate was 20 times/minute, and blood pressure was 120/72 mmHg. The abdomen was soft with tenderness, but there was neither rebounding pain nor muscle guarding. The beta-HCG was in the normal range. The gray-scale ultrasonography revealed hypo-echoic cyst-like lesions (Figure 2A). The color and spectral Doppler ultrasonography demonstrated a hypervascular lesion in the body of the uterus, 2.7 × 2.4 × 2.1 cm with multidirectional turbulent flow, and the resistive index (RI) was 0.4 (Figure 2B and C). The angiography and TAE were arranged afterward. The angiography clearly showed the vascular tangles from the branches of the bilateral internal iliac arteries (Figure 2D). TAE was performed with two microcatheters placed in the bilateral uterine arteries. We injected NBCA slowly till stasis, and the vessels revealed occlusion (Figure 2E). After TAE, the patient had severe abdominal pain and received patient-controlled analgesia for pain control. Because her pain lessened and her condition became stable, the patient was discharged 4 days after treatment. The follow-up color Doppler ultrasonography, which was done 10 days after TAE, confirmed great improvement (Figure 2F). Thirty eight days later, she started normal menstrual periods.


Successful Transarterial Embolization of Uterine Arteriovenous Malformation: Report of Three Cases.

Chen LK, Yang BL, Chen KC, Tsai YL - Iran J Radiol (2016)

A 38-year-old female with hypermenorrhea and intermittent severe abdominal pain for 12 days. A, Transvaginal gray-scale ultrasonography of the uterus shows hypo-echoic cyst-like lesions. B, The color Doppler ultrasonography demonstrates a hypervascular lesion, 2.7 × 2.4 × 2.1 cm with multidirectional turbulent flow at the body of the uterus. The main lesion is in the myometrium. C, Spectral Doppler ultrasonography shows low resistance index of 0.4. D, Angiography shows vascular tangles from the branches of the bilateral internal iliac arteries. E, Bilateral superselective embolization of the uterine arteries was done smoothly. F, The follow-up color Doppler ultrasonography shows a smaller lesion, 2.0 × 1.3 cm with minimal vascularity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835739&req=5

fig23434: A 38-year-old female with hypermenorrhea and intermittent severe abdominal pain for 12 days. A, Transvaginal gray-scale ultrasonography of the uterus shows hypo-echoic cyst-like lesions. B, The color Doppler ultrasonography demonstrates a hypervascular lesion, 2.7 × 2.4 × 2.1 cm with multidirectional turbulent flow at the body of the uterus. The main lesion is in the myometrium. C, Spectral Doppler ultrasonography shows low resistance index of 0.4. D, Angiography shows vascular tangles from the branches of the bilateral internal iliac arteries. E, Bilateral superselective embolization of the uterine arteries was done smoothly. F, The follow-up color Doppler ultrasonography shows a smaller lesion, 2.0 × 1.3 cm with minimal vascularity.
Mentions: A 38-year-old female, G3P0AA3, with a history of regular 30-day menstrual intervals and 4 - 5 days duration of flow visited our outpatient department with the chief complaint of hypermenorrhea and intermittent severe abdominal pain for 12 days. She was in her usual healthy status until 12 days before when she used a massage machine on her belly to relieve constipation. Then she noted intermittent, severe, and dull lower-abdominal pain accompanied by nausea. The next day the vaginal bleeding started, which she thought was normal menses. Over the following 10 days, she found the pain diffused progressively; there was neither relief nor aggravating factor. The vaginal bleeding was persistent with blood clotting. She had no fever, dysuria, urinary frequency, or purulent vaginal discharge. According to the medical record at outpatient department, her temperature was 36.8°C, heart rate was 84 times/minute, respiratory rate was 20 times/minute, and blood pressure was 120/72 mmHg. The abdomen was soft with tenderness, but there was neither rebounding pain nor muscle guarding. The beta-HCG was in the normal range. The gray-scale ultrasonography revealed hypo-echoic cyst-like lesions (Figure 2A). The color and spectral Doppler ultrasonography demonstrated a hypervascular lesion in the body of the uterus, 2.7 × 2.4 × 2.1 cm with multidirectional turbulent flow, and the resistive index (RI) was 0.4 (Figure 2B and C). The angiography and TAE were arranged afterward. The angiography clearly showed the vascular tangles from the branches of the bilateral internal iliac arteries (Figure 2D). TAE was performed with two microcatheters placed in the bilateral uterine arteries. We injected NBCA slowly till stasis, and the vessels revealed occlusion (Figure 2E). After TAE, the patient had severe abdominal pain and received patient-controlled analgesia for pain control. Because her pain lessened and her condition became stable, the patient was discharged 4 days after treatment. The follow-up color Doppler ultrasonography, which was done 10 days after TAE, confirmed great improvement (Figure 2F). Thirty eight days later, she started normal menstrual periods.

Bottom Line: We describe three childbearing-age females, who had abdominal pain and heavy vaginal bleeding, and were diagnosed as uterine AVM by color Doppler and angiography.The patients received successful superselective transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA).Three years after treatment, one of them was admitted to our hospital for vaginal delivery at 39 weeks of gestation, and the baby was healthy.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, National Taiwan University, Taipei, Taiwan.

ABSTRACT
Uterine arteriovenous malformations (AVMs) are relatively rare disorders that can cause life-threatening vaginal bleeding. We describe three childbearing-age females, who had abdominal pain and heavy vaginal bleeding, and were diagnosed as uterine AVM by color Doppler and angiography. The patients received successful superselective transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA). Three years after treatment, one of them was admitted to our hospital for vaginal delivery at 39 weeks of gestation, and the baby was healthy.

No MeSH data available.


Related in: MedlinePlus