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Acquired uterine vascular malformations: radiological and clinical outcome after transcatheter embolotherapy

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Abstract

The purpose of this retrospective study is to assess the radiological and clinical outcome of transcatheter embolization of acquired uterine vascular malformations in patients presenting with secondary postpartum or postabortion vaginal hemorrhage. In a cohort of 17 patients (mean age: 29.7 years; standard deviation: 4.23; range: 25–38 years) 18 embolization procedures were performed. Angiography demonstrated a uterine parenchymal hyperemia with normal drainage into the large pelvic veins (“low-flow uterine vascular malformation”) in 83% (n=15) or a direct arteriovenous fistula (“high-flow uterine vascular malformation”) in 17% (n=3). Clinically, in all patients the bleeding stopped after embolization but in 1 patient early recurrence of hemorrhage occurred and was treated by hysterectomy. Pathological analysis revealed a choriocarcinoma. During follow-up (mean time period: 18.8 months; range: 1–36 months) 6 patients became pregnant and delivered a healthy child. Transcatheter embolization of the uterine arteries, using microparticles, is safe and highly effective in the treatment of a bleeding acquired uterine vascular malformation. In case of clinical failure, an underlying neoplastic disease should be considered. Future pregnancy is still possible after embolization.

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Authors and Affiliations

  1. Department of Radiology, University Hospitals Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium

    Geert Maleux, Sam Heye & Guy Wilms

  2. Department of Obstetrics and Gynecology, University Hospitals Gasthuisberg, Leuven, Belgium

    Dirk Timmerman

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  1. Geert Maleux
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  2. Dirk Timmerman
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  3. Sam Heye
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  4. Guy Wilms
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Correspondence to Geert Maleux.

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Maleux, G., Timmerman, D., Heye, S. et al. Acquired uterine vascular malformations: radiological and clinical outcome after transcatheter embolotherapy. Eur Radiol 16, 299–306 (2006). https://doi.org/10.1007/s00330-005-2799-5

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  • DOI: https://doi.org/10.1007/s00330-005-2799-5

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