Tan Thay Hui, Lau Kenneth K
Monash Imaging, Monash Health, VIC, Clayton, Australia.
School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, Clayton, Australia.
Emerg Radiol. 2025 Sep 10. doi: 10.1007/s10140-025-02386-7.
To evaluate the efficacy and complications of absorbable haemostatic gelatin uterine artery embolisation for symptomatic acquired uterine arterio-venous malformation (UAVM).
All the adult female patients who had acute urogenital bleeding due to UAVM confirmed on ultrasound and received uterine artery embolisation (UAE) for UAVM in a tertiary institution between January 2000 and October 2024 were included. Patients who had UAE for other causes were excluded. Causes of UAVM, embolic agents used, procedural success, recurrent genital bleeding, and complications like pulmonary embolism and groin bleeding were recorded.
Seven female patients (mean age: 34 years) with 8 UAE procedures were included, with three postpartum and four after miscarriages. The mean length of follow-up after UAE was 50 months. Absorbable gelatin was used in six patients, and polyvinyl alcohol (PVA) particles were used in one patient. 5/6 patients (83.3%) had successful UAE with absorbable haemostatic gelatin. There were no procedure-related complications, including pulmonary embolism and uterine infarcts. Only one patient required a repeated UAE 33 days later for recurrent vaginal bleeding, which required sodium tetradecyl sulphate injection and microcoils during embolisation.
Acquired UAVM is very rare but life-threatening. Absorbable haemostatic gelatin, a temporary embolic agent, appears safe and effective in treating UAVM with uterine preservation. It eliminates the potential risk of uterine infarction that might occur with permanent embolic agents.
评估可吸收止血明胶用于有症状的后天性子宫动静脉畸形（UAVM）子宫动脉栓塞术的疗效及并发症。
纳入2000年1月至2024年10月期间在一家三级医疗机构因超声确诊为UAVM而出现急性泌尿生殖系统出血并接受UAVM子宫动脉栓塞术（UAE）的所有成年女性患者。排除因其他原因接受UAE的患者。记录UAVM的病因、所用栓塞剂、手术成功率、复发性生殖器出血以及肺栓塞和腹股沟出血等并发症。
纳入7例女性患者（平均年龄：34岁），共进行了8次UAE手术，其中3例为产后，4例为流产后。UAE术后平均随访时间为50个月。6例患者使用了可吸收明胶，1例患者使用了聚乙烯醇（PVA）颗粒。5/6例患者（83.3%）使用可吸收止血明胶UAE手术成功。未发生包括肺栓塞和子宫梗死在内的与手术相关的并发症。仅1例患者在33天后因复发性阴道出血需要再次进行UAE，此次栓塞期间需要注射十四烷基硫酸钠并使用微线圈。
后天性UAVM非常罕见但危及生命。可吸收止血明胶作为一种临时栓塞剂，在保留子宫治疗UAVM方面似乎安全有效。它消除了永久性栓塞剂可能导致子宫梗死的潜在风险。
