Comparison of temporary abdominal aortic occlusion with internal iliac artery occlusion for patients with placenta accreta - a non-randomised prospective study.
BACKGROUND
To compare the efficacy of temporary abdominal aortic occlusion with internal iliac artery occlusion for the management of placenta accreta.


METHODS
105 patients with placenta accreta were selected for treatment with temporary abdominal aortic occlusion (n = 57, group A) or bilateral iliac artery occlusion (n = 48, group B). Temporary abdominal aortic and internal iliac artery balloon occlusions were performed during caesarean sections. Data regarding the clinical success, blood loss, blood transfusion, balloon insertion time, fluoroscopy time, balloon occlusion time, foetal radiation dose, and complications were collected.


RESULTS
Temporary abdominal aortic occlusion and bilateral internal iliac artery occlusion were technically successful in all patients. The amount of blood loss (P < 0.001), amount of blood transfusion (P < 0.001), balloon insertion time (P < 0.001), foetal radiation dose (P < 0.001) and fluoroscopy time (P < 0.01) in group A were significantly lower than those of patients in group B. No marked differences were found between these 2 groups with respect to age, mean postoperative hospital stay, balloon occlusion time, and Apgar score (p > 0.05).


CONCLUSIONS
Temporary abdominal aortic balloon occlusion resulted in better clinical outcomes with less blood loss, blood transfusion, balloon insertion time, fluoroscopy time and foetal radiation dose than those in bilateral internal iliac balloon occlusion. .
1 Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
Yan-Li
YL
Wang
1 Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
Xu-Hua
XH
Duan
1 Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
Xin-Wei
XW
Han
1 Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
Ling
L
Wang
2 Department of Obstetrics, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
Xian-Lan
XL
Zhao
2 Department of Obstetrics, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
Zhi-Min
ZM
Chen
3 Department of Anesthesiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
Qin-Jun
QJ
Chu
3 Department of Anesthesiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
Wei
W
Zhang
D000328:Adult; D015901:Angiography, Digital Subtraction; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001027:Aortography / Q000379:methods; D021721:Balloon Occlusion / Q000009:adverse effects / Q000379:methods*; D001803:Blood Transfusion; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D010921:Placenta Accreta / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006473:Postpartum Hemorrhage / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies; D012039:Regional Blood Flow; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
Abdominal aorta; balloon catheter; caesarean; embolisation; placenta accrete