Salvage utilization of selective and super selective embolization in emergency by use of a-magnetic coil and nano-particles in gynecology

A. Tinelli, R. Prudenzano*, M. Torsello*, S. Gustapane**, D. Dell’Edera#, A. Malvasi§

Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, Lecce (Italy)

*Department of Radiology, Vito Fazzi Hospital, Lecce (Italy)

**Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, Chieti (Italy)

#Unit of Cytogenetic and Molecular Genetics, “Madonna delle Grazie” Hospital, Matera (Italy)

§Department of Obstetrics and Gynaecology,“Santa Maria” Hospital, Bari (Italy)

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• Gynecology
• Obstetrics

Introduction: 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.
Purpose of Study: 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 anti-thrombosis therapy, with severe anemia.

Materials 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.

Corresponding Author: Andrea Tinelli, MD; e-mail: andreatinelli@gmail.com

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