Giurazza Francesco, Corvino Fabio, Paladini Andrea, Borzelli Antonio, Scognamiglio Domenico, Frauenfelder Giulia, Albano Giuseppe, Sirimarco Fabio, Niola Raffaella
Interventional Radiology Department, Antonio Cardarelli Hospital, Via A. Cardarelli 9, 80100 Naples, Italy.
Maggiore Hospital of Lodi, Viale Savoia 1, 26900 Lodi, Italy.
Case Rep Vasc Med. 2017;2017:3548271. doi: 10.1155/2017/3548271. Epub 2017 Nov 22.
Uterine arteriovenous fistulas are rare and acquired causes of life-threatening vaginal bleeding. They usually present with intermittent menometrorrhagia in young patients in childbearing age with history of gynecological procedures on uterus. Traditional management is hysterectomy; endovascular embolization represents nowadays an alternative strategy for patients wishing to preserve fertility. Here, the endovascular approach to a 29-year-old woman affected by severe menometrorrhagia caused by a uterine arteriovenous fistula with a concomitant pelvic varicocele is reported; a bilateral uterine arteries embolization with Onyx-18 (ev3, Irvine, CA, USA) has successfully resolved the fistula with clinical success.
子宫动静脉瘘是罕见的、后天获得性的危及生命的阴道出血原因。它们通常在有子宫妇科手术史的育龄年轻患者中表现为间歇性月经过多。传统的治疗方法是子宫切除术;对于希望保留生育能力的患者,血管内栓塞术是目前的一种替代策略。本文报道了对一名29岁患有子宫动静脉瘘并伴有盆腔静脉曲张导致严重月经过多的女性采用血管内治疗方法;使用Onyx-18(美国加利福尼亚州尔湾市ev3公司生产)对双侧子宫动脉进行栓塞,成功治愈了瘘管,临床效果良好。