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

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Ryo Takaji ◽  
Hiro Kiyosue ◽  
Miyuki Maruno ◽  
Norio Hongo ◽  
Ryuichi Shimada ◽  
...  
Keyword(s):  
Vaginal Bleeding ◽  
Transarterial Embolization ◽  
Recurrent Bleeding ◽  
Study Cohort ◽  
Technical Success ◽  
Retained Placenta ◽  
Vascular Channel ◽  
Abnormal Bleeding ◽  
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 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.

scholarly journals Angiographic Features and Transarterial Embolization of Retained Placenta With Abnormal Vaginal Bleeding

2021 ◽  
Author(s):  
Ryo Takaji ◽  
Hiro Kiyosue ◽  
Miyuki Maruno ◽  
Norio Hongo ◽  
Ryuichi Shimada ◽  
...  
Keyword(s):  
Vaginal Bleeding ◽  
Transarterial Embolization ◽  
Recurrent Bleeding ◽  
Study Cohort ◽  
Technical Success ◽  
Retained Placenta ◽  
Blood Sinus ◽  
Abnormal Bleeding ◽  
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 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 (tentatively named “serpiginous blood sinus”) 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 “serpiginous blood sinus.” TAE is a safe and effective treatment to manage retained placenta with abnormal bleeding.

Transarterial embolization of peripheral arteriovenous malformations with ethylenevinyl alcohol copolymer - feasibility, technical outcomes, and clinical outcomes

VASA ◽  
2016 ◽  
Vol 45 (6) ◽  
pp. 497-504 ◽  
Author(s):  
Tom De Beule ◽  
Jan Vranckx ◽  
Peter Verhamme ◽  
Veerle Labarque ◽  
Marie-Anne Morren ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Clinical Improvement ◽  
Arteriovenous Malformations ◽  
Clinical Success ◽  
Transarterial Embolization ◽  
Recurrent Bleeding ◽  
Complete Disappearance ◽  
Ethylene Vinyl Alcohol ◽  
Initial Symptoms

Abstract. Background: The technical and clinical outcomes of catheter-directed embolization for peripheral arteriovenous malformations (AVM) using Onyx® (ethylene-vinyl alcohol copolymer) are not well documented. The purpose of this study was to retrospectively assess the safety, technical outcomes and clinical outcomes of catheter-directed Onyx® embolisation for the treatment of symptomatic peripheral AVMs. Patients and methods: Demographics, (pre-)interventional clinical and radiological data were assessed. Follow-up was based on hospital medical records and telephone calls to the patients’ general practitioners. Radiological success was defined as complete angiographic eradication of the peripheral AVM nidus. Clinical success was defined as major clinical improvement or complete disappearance of the initial symptoms. Results: 25 procedures were performed in 22 patients. The principal indications for treatment were pain (n = 10), limb swelling (n = 6), recurrent bleeding (n = 2), tinnitus (n = 3), and exertional dyspnoea (n = 1). Complete radiological success was obtained in eight patients (36 %); near-complete eradication of the nidus was achieved in the remaining 14 patients. Adjunctive embolic agents were used in nine patients (41 %). Clinical success was observed in 18 patients (82%). Major complications were reported in two patients (9 %). During follow-up, seven patients (32 %) presented with symptom recurrence, which required additional therapy in three patients. Conclusions: Catheter-directed embolisation of peripheral AVMs with Onyx® resulted in major clinical improvement or complete disappearance of symptoms in the vast majority of patients, although complete angiographic exclusion of the AVMs occurred in only a minority of patients.

scholarly journals Determine the Frequency of Endometrial Hyperplasia in Female with Abnormal Vaginal Bleeding

2021 ◽  
Vol 15 (7) ◽  
pp. 1779-1781
Author(s):  
Ayesha Naeem ◽  
Amna Aslam ◽  
Amber-u- Nissa ◽  
Tayyaba Rasheed ◽  
Tanweer Akhtar ◽  
...  
Keyword(s):  
Vaginal Bleeding ◽  
Endometrial Hyperplasia ◽  
Economic Status ◽  
Transvaginal Ultrasound ◽  
Adenomatous Hyperplasia ◽  
Cross Sectional ◽  
Socio Economic Status ◽  
Ultrasound Frequency ◽  
Abnormal Bleeding ◽  
Abnormal Vaginal Bleeding

Objective: To determine the frequency of endometrial hyperplasia in female with abnormal vaginal bleeding. Study Design: Cross-sectional Place and Duration of Study: Department of Obstetrics & Gynaecology, Allama Iqbal Memorial Teaching Hospital, Sialkot from 1st January 2021 to 31st March 2021. Methodology: One hundred and ten females with abnormal bleeding were presented in this study. Patients were aged between 40-65 years. Demographically details of age, weight, body mass index and socio economic status were recorded after taking written consent. Complete patients were undergone for transvaginal ultrasound. Frequency of endometrial hyperplasia was recorded. Results: Mean age of the females was 47.16±7.53 years with mean BMI 26.17±8.44 kg/m2. Mean weight of the patients were 59.16±17.66 kg. Most of the patients 65 (59.09%) were from urban area and majority of the patients 70 (63.64%) were illiterate. Sixty (54.5%) cases were from low socio-economic status and 50 (45.5%) had high socio-economic status. Endometrial hyperplasia was found in 25 (22.73%) patients, in which 18 (72%) had cystic hyperplasia, adenomatous hyperplasia found in 4 (16%) and 3 (12%) had atypical hyperplasia. Among 25 cases of hyperplasia, menorrhagia found in 15 (60%), polymenorrhea found in 8 (32%) and polymenorrhagia in 2 (8%). Medical treatment were given to 20 (80%) cases and surgical treatment were given to 5 (20%). Conclusion: The prevalence of endometrial hyperplasia was 22.73% among women with abnormal bleeding. It can be cure by early diagnosis and treatment. Keywords: Transvaginal ultrasound (TVS), Endometrial hyperplasia, Abnormal vaginal bleeding, Menorrhagia

scholarly journals Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations

CytoJournal ◽  
2014 ◽  
Vol 11 ◽  
pp. 29 ◽  
Author(s):  
Longwen Chen ◽  
Christine N. Booth ◽  
Julie A. Shorie ◽  
Jennifer A. Brainard ◽  
Matthew A. Zarka
Keyword(s):  
Vaginal Bleeding ◽  
Pap Test ◽  
Pap Tests ◽  
Endometrial Cells ◽  
Clinical Presentations ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
Abnormal Vaginal Bleeding ◽  
Endometrial Pathology

The 2001 Bethesda system recommends further classifying atypical glandular cells (AGCs) as either endocervical or endometrial origin. Numerous studies have investigated the clinical significance of AGC. In this study, we investigated the incidence of clinically significant lesions among women with liquid-based Papanicolaou cervicovaginal (Pap) interpretations of atypical endometrial cells (AEMs) or AGC favor endometrial origin (AGC-EM). More importantly, we correlated patients of AEM or AGC-EM with their clinical presentations to determine if AEM/AGC-EM combined with abnormal vaginal bleeding is associated with a higher incidence of significant endometrial pathology. All liquid-based Pap tests with an interpretation of AEM and AGC-EM from July, 2004 through June, 2009 were retrieved from the database. Women with an interpretation of atypical endocervical cells, AGC, favor endocervical origin or AGC, favor neoplastic were not included in the study. The most severe subsequent histologic diagnoses were recorded for each patient. During this 5-year period, we accessioned 332,470 Pap tests of which 169 (0.05%) were interpreted as either AEM or AGC-EM. Of the 169 patients, 133 had histologic follow-up within the health care system. The patients ranged in age from 21 to 71 years old (mean 49.7). On follow-up histology, 27 (20.3%) had neoplastic/preneoplastic uterine lesions. Among them, 20 patients were diagnosed with adenocarcinoma (18 endometrial, 1 endocervical, and 1 metastatic colorectal), 3 with atypical endometrial hyperplasia, and 4 with endometrial hyperplasia without atypia. All patients with significant endometrial pathology, except one, were over 40 years old, and 22 of 25 patients reported abnormal vaginal bleeding at the time of endometrial biopsy or curettage. This study represents a large series of women with liquid-based Pap test interpretations of AEM and AGC-EM with clinical follow-up. Significant preneoplastic or neoplastic endometrial lesions were identified in 20.3% of patients. Patients with Pap test interpretations of AEM or AGC-EM and the clinical presentation of abnormal vaginal bleeding should be followed closely.

scholarly journals Uterine Tumor Resembling Ovarian Sex-Cord Tumors Initially Diagnosed as a Prolapsed Fibroid

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Fernando Augusto Rozário Garcia ◽  
Vanessa Pereira Gaigher ◽  
Rodrigo Neves Ferreira ◽  
Antônio Chambô Filho
Keyword(s):  
Vaginal Bleeding ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Tumors ◽  
Menopausal Women ◽  
Patient Will ◽  
One Year ◽  
Abnormal Vaginal Bleeding

Background. First described in 1945 by Morehead and Bowman, uterine tumors resembling ovarian sex-cord tumors (UTROSCT) are rare tumors of the uterine body that tend to occur in menopausal women presenting with abnormal vaginal bleeding, abdominal pain, and increased uterine volume. UTROSCT are usually diagnosed from incidental histological findings following hysterectomy performed due to a suspected endometrial polyp or uterine fibroids. Objective. To report on a 46-year-old patient with abnormal vaginal bleeding. At physical examination, a pediculated nodular lesion was found protruding from the external cervical os. Histopathology of the resected lesion led to a diagnosis of UTROSCT. Total abdominal hysterectomy with bilateral adnexectomy was then performed. The patient is currently undergoing regular outpatient follow-up, with no evidence of disease after one year. Methods. Data were retrieved from the patient’s records, and macroscopic and microscopic images of the tumor were obtained. Discussion. Reports of metastasis or recurrence are rare. UTROSCT are considered of uncertain malignant potential and no particular form of treatment is formally recommended, with hysterectomy currently being the treatment of choice. This patient will be followed up for five years during which clinical examination and tomography of the chest, abdomen, and pelvis will be performed annually.

Portal vein stent placement with or without varix embolization of jejunal variceal bleeding after hepatopancreatobiliary surgery

2016 ◽  
Vol 58 (4) ◽  
pp. 423-429 ◽  
Author(s):  
Dong Jae Shim ◽  
Ji Hoon Shin ◽  
Gi-Young Ko ◽  
Yook Kim ◽  
Kichang Han ◽  
...  
Keyword(s):  
Portal Vein ◽  
Stent Placement ◽  
Variceal Bleeding ◽  
Clinical Success ◽  
Recurrent Bleeding ◽  
Technical Success ◽  
Stent Patency ◽  
Stent Occlusion ◽  
Before And After

Background Extrahepatic portal hypertension after surgery involving the duodenum or jejunum might result in massive ectopic variceal bleeding. Purpose To report the results of portal vein stent placement with the addition of variceal embolization. Material and Methods Between January 2000 and June 2015, portal vein stent placement was attempted in 477 patients. Of these, 22 patients (age, 63 ± 10 years) with jejunal variceal bleeding caused by portal vein obstruction after surgery were included in this study. Computed tomography (CT) findings before and after treatment and the rates of technical and clinical success, complications, and clinical outcomes were retrospectively evaluated. Results Stent placement was successful in 19 of 22 patients. Additional variceal embolization was performed in five cases. Clinical success, defined as the cessation of bleeding without recurrence within 1 month, was achieved in 18 of 19 patients with technical success. One patient developed recurrent bleeding 4 days after stent placement and was successfully treated with additional variceal embolization. There were no procedure-related complications. A regression of the jejunal varices was noted in 14 of 19 patients on follow-up CT scans. During the follow-up period (258 days; range, 7–1196 days), stent occlusion and recurrent bleeding occurred in six and four patients, respectively, of the 19 patients who achieved technical success. Statistical analyses revealed no significant differences regarding stent patency between benign and malignant strictures. Conclusion Percutaneous, transhepatic, portal vein stent placement with or without jejunal variceal embolization appears to be a safe and effective treatment for jejunal variceal bleeding after surgery.

Direct sac puncture versus transarterial embolization of type II endoleaks: An evaluation and comparison of outcomes

Vascular ◽  
2016 ◽  
Vol 25 (3) ◽  
pp. 227-233 ◽  
Author(s):  
Roy Y Yang ◽  
Kong T Tan ◽  
J Robert Beecroft ◽  
Dheeraj K Rajan ◽  
Jeffrey D Jaskolka
Keyword(s):  
Transarterial Embolization ◽  
Type Ii ◽  
Technical Success ◽  
Cyanoacrylate Glue ◽  
Type Ii Endoleak ◽  
Technical Success Rate ◽  
Ruptured Aneurysms ◽  
Feeding Vessels ◽  
Total Procedure

Purpose To determine the outcomes of type II endoleak embolization with aneurysm sac obliteration and whether the approach – direct sac puncture or transarterial – affects outcome. Methods A retrospective review of patients who underwent endovascular aneurysm repairs and subsequent type II endoleak embolization over 10 years was performed. Twenty-three patients (median age: 73 years, range: 40–88 years) underwent 35 embolizations. Embolization was performed with the goal of obliterating both the endoleak sac and feeding vessels. Embolization agents used include cyanoacrylate glue only (48%), glue and coils (36%), coils only (13%), and other (3%). Results Mean follow-up was 21.8 months. Patients underwent an average of 1.5 embolizations, with 35% requiring more than one. Technical success rate was 89%. Freedom from aneurysm sac expansion was achieved in 91%. Freedom from type II endoleak was accomplished in 70%. There were no ruptured aneurysms during the follow-up period. Direct sac puncture and transarterial approaches had similar incidences of aneurysm sac growth ( p = 0.74), persistent type II endoleak ( p = 0.32), and complications ( p = 0.64). However, direct sac puncture had significantly shorter fluoroscopy ( p < 0.001) and total procedure times ( p < 0.001) than transarterial embolizations. Conclusion Direct sac puncture and transarterial embolization of type II endoleak with aneurysm sac obliteration are similarly effective for the prevention of aneurysm sac growth. However, direct sac puncture is our preferred approach given its significantly shorter fluoroscopic and procedural times.

scholarly journals ENDOMETRIAL STUDY OF ABNORMAL UTERINE BLEEDING IN WOMEN AT 45 YEARS AND ABOVE

2003 ◽  
Vol 42 (146) ◽  
pp. 83-85
Author(s):  
Ganesh Dangal
Keyword(s):  
Vaginal Bleeding ◽  
Elderly Women ◽  
Abnormal Uterine Bleeding ◽  
The Elderly ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Perimenopausal Women ◽  
Abnormal Bleeding ◽  
Post Menopausal ◽  
Abnormal Vaginal Bleeding

ABSTRACTThe study is done to know the causes for the abnormal uterine bleeding in perimenopausal women atChitwan valley and to compare the histopathological findings between the pre-menopausal andpostmenopausal women. Retrospective analysis of patients who have had abnormal bleeding during a periodof one and a half years' from January 2000 to June 2001 in Department of Gynaecological Oncology of BPKoirala Memorial Cancer Hospital (BPKMCH), Chitwan, Nepal. There were total sixty women (aged 45years and above) having abnormal bleeding managed at BPKMCH. A total of sixty patients were studied.Majority (57%) of them was postmenopausal ladies presented with abnormal vaginal bleeding. The agerange was 45 to 81 years. Only 37% had pathological bleeding including malignancies and only about 17%had malignancies. Malignant diseases were found in 7.7% cases in the pre-menopausal ladies whereas itwas 23.4%, almost three times higher, in the post-menopausal ladies. Carcinoma of the cervix and of theendometrium occurred with increasing frequency with increasing age in this study. So, a thorough work-upis needed for the elderly women presenting with an abnormal vaginal bleeding especially to rule outmalignancies.Key Words: endometrial biopsy, endometrial cancer, postmenopausal bleeding.

Thrombolysis of Occluded Synthetic Bypass Grafts in the Lower Limb: Technical Success and 1-Year Follow-up in 32 Patients

2003 ◽  
Vol 10 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Jacqueline van Holten ◽  
Lukas C. van Dijk ◽  
Marc R. H. M. van Sambeek ◽  
Hero van Urk ◽  
Hans van Overhagen ◽  
...  
Keyword(s):  
Lower Limb ◽  
Bypass Grafts ◽  
Technical Success

Gamma Knife surgery for low-flow cavernous sinus dural arteriovenous fistulas

2010 ◽  
Vol 113 (Special_Supplement) ◽  
pp. 21-27 ◽  
Author(s):  
Hyun Ho Jung ◽  
Jong Hee Chang ◽  
Kum Whang ◽  
Jin Soo Pyen ◽  
Jin Woo Chang ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Cavernous Sinus ◽  
Transarterial Embolization ◽  
Gamma Knife Surgery ◽  
Low Flow ◽  
Close Monitoring ◽  
Arteriovenous Fistulas ◽  
Ocular Symptoms ◽  
Dural Arteriovenous Fistulas

Object The purpose of this study was to assess the efficacy of Gamma Knife surgery (GKS) for treating cavernous sinus dural arteriovenous fistulas (CSDAVFs). Methods Of the 4123 GKSs performed between May 1992 and March 2009, 890 procedures were undertaken to treat vascular lesions. In 24 cases, the vascular lesion that was treated was a dural arteriovenous fistula, and in 6 of these cases, the lesion involved the cavernous sinus. One of these 6 cases was lost to follow-up, leaving the other 5 cases (4 women and 1 man) to comprise the subjects of this study. All 5 patients had more than 1 ocular symptom, such as ptosis, chemosis, proptosis, and extraocular movement palsy. In all patients, CSDAVF was confirmed by conventional angiography. Three patients were treated by GKS alone and 2 patients were treated by GKS combined with transarterial embolization. The median follow-up period after GKS in these 5 cases was 30 months (range 9–59 months). Results All patients experienced clinical improvement, and their improvement in ocular symptoms was noticed at a mean of 17.6 weeks after GKS (range 4–24 weeks). Two patients received embolization prior to GKS but did not display improvement in ocular symptoms. An average of 20 weeks (range 12–24 weeks) was needed for complete improvement in clinical symptoms. There were no treatment-related complications during the follow-up period. Conclusions Gamma Knife surgery should be considered as a primary, combined, or additional treatment option for CSDAVF in selected cases, such as when the lesion is a low-flow shunt without cortical venous drainage. For those selected cases, GKS alone may suffice as the primary treatment method when combined with close monitoring of ocular symptoms and intraocular pressure.

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