title: Efficacy and safety of embolization in iatrogenic traumatic uterine vascular malformations.
abstract: OBJECTIVE
  To retrospectively evaluate the efficacy of embolotherapy in patients with iatrogenic traumatic uterine arteriovenous malformations (AVMs).
  
  
  METHODS
  A retrospective review of all patients who underwent uterine arterial embolization in Peking Union Medical College Hospital between January 2000 and December 2010 was performed. Forty-two patients were diagnosed with a uterine vascular malformation. All patients had obstetric manipulations before. Serial beta-human chorionic gonadotropin (β-HCG) levels were measured to exclude gestational trophoblastic neoplasia. All patients underwent transcatheter embolization of bilateral uterine arteries. The complications, control of haemorrhage, and outcome of subsequent pregnancies were assessed.
  
  
  RESULTS
  A total of 49 embolization procedures were performed in 42 patients. Seven patients required repeated embolizations for recurrence of bleeding. The technical success rate of embolization was 100%. Bleeding was controlled in 35 of 42 patients (83%) after the first embolization procedures, and bleeding was controlled in another two patients who underwent repeat embolization at a median follow-up of 29 months (range 3 months to 5 years). The overall clinical success rate was 88% (37/42). Thirteen patients subsequently became pregnant and eight of 13 patients had uneventful intrauterine pregnancies carried to term. Seven patients had post-embolization syndrome and no other complication occurred.
  
  
  CONCLUSIONS
  Percutaneous embolotherapy is a safe and effective treatment for traumatic AVMs. Future pregnancy is still possible after embolization.
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: H
authors.initials: H
authors.lastname: Shi
authors.forename: K
authors.initials: K
authors.lastname: Zhou
authors.forename: H
authors.initials: H
authors.lastname: Sun
authors.forename: X
authors.initials: X
authors.lastname: Li
authors.forename: J
authors.initials: J
authors.lastname: Pan
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: W
authors.initials: W
authors.lastname: Liu
authors.forename: N
authors.initials: N
authors.lastname: Yang
authors.forename: Z
authors.initials: Z
authors.lastname: Jin
mesh_terms: D000293:Adolescent; D000328:Adult; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005780:Gelatin / Q000627:therapeutic use; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D007049:Iatrogenic Disease; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D015641:Radiography, Interventional / Q000379:methods; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D014599:Uterus / Q000098:blood supply* / Q000293:injuries; D054079:Vascular Malformations / Q000628:therapy*; D055815:Young Adult
chemical_list: D005780:Gelatin