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Novel approach to uterine artery pseudoaneurysm embolization for delayed post‐partum hemorrhage
Author(s) -
Parker Ross,
Wuerdeman Marc,
Grant Matthew,
Kitley Charles
Publication year - 2016
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13140
Subject(s) - medicine , embolization , arterial embolization , pseudoaneurysm , post partum , surgery , uterine artery , radiology , uterine artery embolization , thrombin , aneurysm , pregnancy , platelet , gestation , biology , genetics
Abstract Uterine artery pseudoaneurysms (UAP) are a rare cause of post‐partum hemorrhage. Conservative management is discouraged due to the risk of spontaneous hemorrhage. Intra‐arterial embolization is highly successful (>90%) and offers definitive treatment. We present the case of a 27‐year‐old woman with significant delayed post‐partum hemorrhage after cesarean section who was found to have a UAP on imaging. Her tortuous vascular anatomy and spasmodic aneurysmal neck presented technical challenges to embolization with traditional material, such as gel foam and coils. Intra‐arterial thrombin was then employed with good technical and clinical outcome. To our knowledge, this is the first case describing the use of intra‐arterial thrombin in the treatment of UAP. Given its success in this case, we argue that intra‐arterial thrombin should be considered a viable alternative for embolization of UAP when more traditional techniques fail.