Salvage utilization of selective and super selective embolization in emergency by use of a-magnetic coil and nano-particles in gynecology.
BACKGROUND
Pelvic arteries embolization (PAE) can be described as an obstetric procedure effective in emergencies, to use especially in managing uncontrollable acute uterine hemorrhage, if resistant to medical therapy. This procedure leads to immediate control of hemorrhages and restores cardiovascular status, especially in critical patients. PAE can be used as an alternative to removing organs.


OBJECTIVE
To utilize the PAE in local anesthesia for management of acute uterine hemorrhage for cervical myoma in a critical patients, a fertile woman with concomitant cardiovascular stroke and in high-dosage of antithrombosis therapy, with severe anemia. MATERIAL ANDS METHODS: This procedure was used in an University affiliated Hospital, by a selective catheterization of the left hypogastric artery with an a-magnetic coil and super-selective catheterization of the right uterine artery, instilling a mixture of micro-particles and an absorbable haemostatic gelatin.


RESULTS
Authors have successfully completed this procedure in 40 minutes in local anaesthesia, showed by stopping of iodated contrast fluid in vascular myoma network, with subsequent cervical myomectomy, whilst preserving uterus.


CONCLUSIONS
PAE allows, through super-selective catheterization of both uterine arteries or selective catheterization of hypogastric arteries, to instill a mixture of micro-particles, absorbable haemostatic gelatins or endovascular coils, mixed with iodated contrast fluid and, thereby, to stop bleeding. This procedure leaded to an immediate control of hemorrhages and restores cardiovascular status, as an alternative to removing organs.
Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, Lecce, Italy. andreatinelli@gmail.com
A
A
Tinelli
R
R
Prudenzano
M
M
Torsello
S
S
Gustapane
D
D
Dell'Edera
A
A
Malvasi
D000328:Adult; D004630:Emergencies; D004867:Equipment Design; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007889:Leiomyoma / Q000098:blood supply / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D053758:Nanoparticles; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000295:instrumentation*; D002583:Uterine Cervical Neoplasms / Q000098:blood supply / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014592:Uterine Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
D006490:Hemostatics