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胎盘异常中的预防性封堵球囊:每位介入放射科医生都需要了解的内容。

Prophylactic occlusion balloon in placenta abnormalities: What every interventional radiologist needs to know.

作者信息

Steri Lorenzo, Barbieri Pierluigi, Gigante Lavinia, Posa Alessandro

机构信息

Department of Diagnostic Imaging, Ospedale Isola Tiberina Gemelli Isola, Rome 00186, Lazio, Italy.

Department of Diagnostic Imaging and Radiation Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Lazio, Italy.

出版信息

World J Radiol. 2025 Jul 28;17(7):107737. doi: 10.4329/wjr.v17.i7.107737.

Abstract

Placenta abnormalities, which are collectively termed as placenta accreta spectrum (PAS), are increasing globally in the female population due to the large number of cesarean sections performed worldwide. PAS represents a rare but life-threatening occurrence that can lead to an increased risk of postpartum hemorrhage due to the abnormal infiltration of the chorionic villi in the uterine wall up to the adjacent structures. Performing a prophylactic occlusion of the iliac arteries for a brief amount of time using balloon-occlusion endovascular catheters in patients with PAS can help control unwanted blood losses during cesarean delivery or postpartum demolition surgery. The aim of this narrative minireview was to provide an overview of the aspects about prophylactic occlusion with endovascular balloons in patients with PAS and to analyze current evidence on this topic. In particular, this minireview included an overview of indications, patient selection, type of materials and devices used, technical advice and suggestions, clinical outcomes, and complications to give every interventional radiologist as well as every gynecologist and midwife all the information that is needed to address this particular condition in a safe and prompt manner.

摘要

胎盘异常,统称为胎盘植入谱系障碍(PAS),由于全球范围内进行的大量剖宫产手术,在女性人群中呈上升趋势。PAS是一种罕见但危及生命的情况,由于绒毛膜绒毛异常浸润子宫壁直至邻近结构,可导致产后出血风险增加。对于患有PAS的患者,使用球囊闭塞血管内导管对髂动脉进行短时间的预防性闭塞,有助于在剖宫产或产后拆除手术期间控制不必要的失血。本叙述性综述的目的是概述PAS患者血管内球囊预防性闭塞的相关方面,并分析该主题的现有证据。特别是,本综述包括适应症、患者选择、所用材料和设备类型、技术建议、临床结果和并发症的概述,以便为每位介入放射科医生以及每位妇科医生和助产士提供安全、迅速处理这一特殊情况所需的所有信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0fb/12308548/bd40809a4665/wjr-17-7-107737-g001.jpg

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