Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, Lecce, Italy.
Eur Rev Med Pharmacol Sci. 2011 Sep;15(9):1101-6.
Pelvic arteries embolization (PAE) can be described as an obstetric procedure effective in emergencies, to use especially in managing uncontrollable acute uterine hemorrhage, if resistant to medical therapy. This procedure leads to immediate control of hemorrhages and restores cardiovascular status, especially in critical patients. PAE can be used as an alternative to removing organs.
To utilize the PAE in local anesthesia for management of acute uterine hemorrhage for cervical myoma in a critical patients, a fertile woman with concomitant cardiovascular stroke and in high-dosage of antithrombosis therapy, with severe anemia. MATERIAL ANDS METHODS: This procedure was used in an University affiliated Hospital, by a selective catheterization of the left hypogastric artery with an a-magnetic coil and super-selective catheterization of the right uterine artery, instilling a mixture of micro-particles and an absorbable haemostatic gelatin.
Authors have successfully completed this procedure in 40 minutes in local anaesthesia, showed by stopping of iodated contrast fluid in vascular myoma network, with subsequent cervical myomectomy, whilst preserving uterus.
PAE allows, through super-selective catheterization of both uterine arteries or selective catheterization of hypogastric arteries, to instill a mixture of micro-particles, absorbable haemostatic gelatins or endovascular coils, mixed with iodated contrast fluid and, thereby, to stop bleeding. This procedure leaded to an immediate control of hemorrhages and restores cardiovascular status, as an alternative to removing organs.
经子宫动脉栓塞术(PAE)可被视为一种有效的产科急症处理方法,尤其适用于治疗药物治疗无效的不可控制的急性子宫大出血。该方法可立即控制出血并恢复心血管状态,尤其适用于危急患者。PAE 可作为去除器官的替代方法。
在局部麻醉下,对伴有心血管卒中的、正在进行高剂量抗凝治疗的、有严重贫血的、有生育能力的、患有宫颈肌瘤的危急患者,使用 PAE 治疗急性子宫出血。
该程序在一所大学附属医院进行,通过对左侧子宫动脉进行磁性线圈的选择性导管插入术和右侧子宫动脉的超选择性导管插入术,将微颗粒和可吸收止血明胶的混合物注入。
作者在局部麻醉下成功地在 40 分钟内完成了该程序,通过血管肌瘤网络中的碘对比液停止,随后进行宫颈肌瘤切除术,同时保留子宫。
PAE 通过对双侧子宫动脉进行超选择性导管插入术或对子宫动脉进行选择性导管插入术,将微颗粒、可吸收止血明胶或血管内线圈的混合物与碘对比液混合注入,从而实现止血。该方法可立即控制出血并恢复心血管状态,作为去除器官的替代方法。