Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding

Abstract Objectives To clarify characteristic angiographic features and clinical efficacy of selective transarterial embolization (TAE) of retained placenta with abnormal vaginal bleeding. Methods The study cohort comprised 22 patients (mean age, 33.5 years; range, 22–24 years) who underwent selecti...

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Autores principales:	Ryo Takaji, Hiro Kiyosue, Miyuki Maruno, Norio Hongo, Ryuichi Shimada, Satomi Ide, Kohei Tokuyama, Mamiko Okamoto, Yasushi Kawano, Yoshiki Asayama
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Retained placenta Angiography Transarterial embolization Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/ad5ba6c92be540cc938aefeb2202d4b9
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spelling	oai:doaj.org-article:ad5ba6c92be540cc938aefeb2202d4b92021-11-08T11:17:35ZAngiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding10.1186/s42155-021-00265-z2520-8934https://doaj.org/article/ad5ba6c92be540cc938aefeb2202d4b92021-11-01T00:00:00Zhttps://doi.org/10.1186/s42155-021-00265-zhttps://doaj.org/toc/2520-8934Abstract Objectives To clarify characteristic angiographic features and clinical efficacy of selective transarterial embolization (TAE) of retained placenta with abnormal vaginal bleeding. Methods The study cohort comprised 22 patients (mean age, 33.5 years; range, 22–24 years) who underwent selective TAE for retained placenta with abnormal bleeding between January 2018 and December 2020 at our institution. Angiographic images were reviewed by two certified radiologists with consensus. Medical records were reviewed to evaluate the efficacy of TAE. Angiographic features of retained placenta, technical success (disappearance of abnormal findings on angiography), complications, clinical outcomes (hemostatic effects and recurrent bleeding) were evaluated. Results Pelvic angiography showed a dilated vascular channel mimicking arteriovenous fistulas or an aneurysm contiguous with dilated uterine arteries in the mid-arterial–capillary phase in 20 patients; it showed contrast brush in the remaining two patients. TAE technical success was achieved in all patients. No major complications were observed in any patients. Fifteen patients were followed up with expectant management after TAE; all but one patient showed no re-bleeding during the follow-up period (mean follow-up interval, 3.4 months; range, 1–17 months). One patient showed minor rebleeding, which resolved spontaneously. Seven patients underwent scheduled hysteroscopic resection within 1 week after TAE, and no excessive bleeding was observed during or after the surgical procedure in all seven patients. Conclusions The characteristic angiographic feature of retained placenta is “dilated vascular channel that mimic low flow AVM.” TAE is a safe and effective treatment to manage retained placenta with abnormal bleeding.Ryo TakajiHiro KiyosueMiyuki MarunoNorio HongoRyuichi ShimadaSatomi IdeKohei TokuyamaMamiko OkamotoYasushi KawanoYoshiki AsayamaSpringerOpenarticleRetained placentaAngiographyTransarterial embolizationDiseases of the circulatory (Cardiovascular) systemRC666-701ENCVIR Endovascular, Vol 4, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Retained placenta Angiography Transarterial embolization Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Retained placenta Angiography Transarterial embolization Diseases of the circulatory (Cardiovascular) system RC666-701 Ryo Takaji Hiro Kiyosue Miyuki Maruno Norio Hongo Ryuichi Shimada Satomi Ide Kohei Tokuyama Mamiko Okamoto Yasushi Kawano Yoshiki Asayama Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding
description	Abstract Objectives To clarify characteristic angiographic features and clinical efficacy of selective transarterial embolization (TAE) of retained placenta with abnormal vaginal bleeding. Methods The study cohort comprised 22 patients (mean age, 33.5 years; range, 22–24 years) who underwent selective TAE for retained placenta with abnormal bleeding between January 2018 and December 2020 at our institution. Angiographic images were reviewed by two certified radiologists with consensus. Medical records were reviewed to evaluate the efficacy of TAE. Angiographic features of retained placenta, technical success (disappearance of abnormal findings on angiography), complications, clinical outcomes (hemostatic effects and recurrent bleeding) were evaluated. Results Pelvic angiography showed a dilated vascular channel mimicking arteriovenous fistulas or an aneurysm contiguous with dilated uterine arteries in the mid-arterial–capillary phase in 20 patients; it showed contrast brush in the remaining two patients. TAE technical success was achieved in all patients. No major complications were observed in any patients. Fifteen patients were followed up with expectant management after TAE; all but one patient showed no re-bleeding during the follow-up period (mean follow-up interval, 3.4 months; range, 1–17 months). One patient showed minor rebleeding, which resolved spontaneously. Seven patients underwent scheduled hysteroscopic resection within 1 week after TAE, and no excessive bleeding was observed during or after the surgical procedure in all seven patients. Conclusions The characteristic angiographic feature of retained placenta is “dilated vascular channel that mimic low flow AVM.” TAE is a safe and effective treatment to manage retained placenta with abnormal bleeding.
format	article
author	Ryo Takaji Hiro Kiyosue Miyuki Maruno Norio Hongo Ryuichi Shimada Satomi Ide Kohei Tokuyama Mamiko Okamoto Yasushi Kawano Yoshiki Asayama
author_facet	Ryo Takaji Hiro Kiyosue Miyuki Maruno Norio Hongo Ryuichi Shimada Satomi Ide Kohei Tokuyama Mamiko Okamoto Yasushi Kawano Yoshiki Asayama
author_sort	Ryo Takaji
title	Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding
title_short	Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding
title_full	Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding
title_fullStr	Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding
title_full_unstemmed	Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding
title_sort	angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/ad5ba6c92be540cc938aefeb2202d4b9
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Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding

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