CVIR Endovascular最新文献

{"title":"Investigating the effects of percutaneous endovascular aneurysm repair for abdominal aortic aneurysm on the lumen size of the common femoral artery","authors":"Wilson Wei Xiang Ong, Hsien Ts’ung Tay, Tze Tec Chong","doi":"10.1186/s42155-024-00476-0","DOIUrl":"https://doi.org/10.1186/s42155-024-00476-0","url":null,"abstract":"Percutaneous endovascular aneurysm repair (PEVAR) is the definitive therapy of choice for abdominal aortic aneurysms worldwide. However, current literature regarding the anatomic changes in the common femoral artery (CFA) post-PEVAR is sparse and contradictory, and a significant proportion of these studies did not control for the potential confounding effects of ethnicity. Thus, this study aims to investigate the anatomical effects of PEVAR on the CFA using an Asian study cohort. Between January 2019 and September 2023, the records of 113 patients who received PEVAR were reviewed. Groins with previous surgical interventions were excluded. The most proximate pre- and postoperative CT angiography of patients receiving PEVAR via the Perclose ProGlide™ Suture-Mediated Closure System were retrospectively analysed for changes in both the CFA inner luminal diameter (ID) and outer diameter (OD), the latter also encompassing the arterial walls. Access site complications within 3 months post-PEVAR were also recorded per patient. One hundred seventeen groins from 60 patients were included in this study, with 1 report of pseudoaneurysm. The CFA ID exhibited a 0.167 mm decrease (p-value = 0.0403), while the OD decreased by 0.247 mm (p-value = 0.0107). This trend persisted when the data was separately analysed with the common cardiovascular risk factors of diabetes mellitus, hypertension and hyperlipidaemia. Our analysis demonstrated a statistically significant decrease in the CFA diameters post-PEVAR. However, the percentage changes were below established flow-limiting values, as reflected by the single access site complication reported. Hence, our findings give confidence in the safety profile of this procedure, even with the reported smaller baseline CFA lumen size in Asians. Moving forward, similar longer-term studies should be considered to characterise any late postoperative effects. ","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"161 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transjugular antegrade transvenous obliteration, with and without portal decompression, for management of rectal variceal hemorrhage.","authors":"Gabriel E Li, Jeffrey Forris Beecham Chick, Eric J Monroe, Matthew Abad-Santos, Ethan W Hua, David S Shin","doi":"10.1186/s42155-024-00479-x","DOIUrl":"10.1186/s42155-024-00479-x","url":null,"abstract":"<p><strong>Purpose: </strong>To report antegrade transvenous obliteration, with or without concurrent portosystemic shunt creation, for the treatment of hemorrhagic rectal varices.</p><p><strong>Materials and methods: </strong>Eight patients, including five (62.5%) females and three (37.5%) males, with mean age of 55.8 ± 13.8 years (range: 30-70 years), underwent transjugular-approach antegrade transvenous obliteration of rectal varices, with or without portosystemic shunt creation. Demographic data, procedural details, technical success of variceal obliteration, clinical success, adverse events, and follow-up outcomes were retrospectively recorded. Clinical success was defined as resolution of rectal hemorrhage.</p><p><strong>Results: </strong>Portal venous access was achieved via a transjugular intrahepatic approach in all patients. The inferior mesenteric vein was selected, and foamy sclerosant (1:2:3 mixture by volume of ethiodized oil: sodium tetradecyl sulfate: air) was injected into the rectal varices with antegrade balloon occlusion in seven (87.5%) and without balloon occlusion in one (12.5%). Five of eight (62.5%) patients underwent concomitant transjugular intrahepatic portosystemic shunt (TIPS) creation (mean diameter 8.4 ± 0.9-mm) immediately following transvenous obliteration. Technical success of variceal obliteration was achieved in all patients. There were no immediate post-procedural adverse events. There were no reported occurrences of rectal ischemia, perforation, or stricture following obliteration. Two (40%) of the patients who underwent concomitant TIPS creation developed hepatic encephalopathy within 30 days of the procedure, which was medically managed. Clinical resolution of hemorrhage was achieved in all patients with no recurrent rectal variceal hemorrhage during mean follow-up of 666 ± 396 days (range: 14 - 1,224 days).</p><p><strong>Conclusion: </strong>Transvenous obliteration, with or without concurrent TIPS creation, is feasible with promising results for the management of rectal variceal hemorrhage.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"65"},"PeriodicalIF":1.2,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transfemoral hepatic vein access in double vein embolization - initial experience and feasibility.","authors":"Ulrik Carling, Sigurd Berger, Eyvind Gjønnæss, Bård Røsok, Sheraz Yaqub, Kristoffer Lassen, Åsmund Avdem Fretland, Eric Dorenberg","doi":"10.1186/s42155-024-00478-y","DOIUrl":"10.1186/s42155-024-00478-y","url":null,"abstract":"<p><strong>Background: </strong>Hepatic vein embolization in double vein embolization (DVE) can be performed with transhepatic, transjugular or transfemoral access. This study evaluates the feasibility and technical success of using a transfemoral access for the hepatic vein embolization in patients undergoing preoperative to induce hypertrophy of the future liver remnant (FLR).</p><p><strong>Material and methods: </strong>Retrospective analysis of single center cohort including 17 consecutive patients. The baseline standardized FLR was 18.2% (range 14.7-24.9). Portal vein embolization was performed with vascular plugs and glue through an ipsilateral transhepatic access. Hepatic vein embolization was performed using vascular plugs. Access for the hepatic vein was either transhepatic, transjugular or transfemoral. Technical success, number of hepatic veins embolized and complications were registered. In addition, volumetric data including degree of hypertrophy (DH) and kinetic growth rate (KGR), and resection data were registered. R: Seven of the 17 patients had transfemoral hepatic vein embolization, with 100% technical success. No severe complications were registered. In the whole cohort, the median number of hepatic veins embolized was 2 (1-6). DH was 8.6% (3.0-19.4) and KGR was 3.6%/week (1.4-7.4), without significant differences between the patients having transfemoral versus transhepatic /transjugular access (p = 0.48 and 0.54 respectively). Time from DVE to surgery was median 4.8 weeks (2.6-33.9) for the whole cohort, with one patient declining surgery, two having explorative laparotomy and one patient having change of surgical strategy due to insufficient growth.</p><p><strong>Conclusion: </strong>Transfemoral access is a feasible option with a high degree of technical success for hepatic vein embolization in patients with small future liver remnants needing DVE.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"64"},"PeriodicalIF":1.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic locations of ureterovascular fistulae: a review of 532 patients in the literature and a new series of 8 patients.","authors":"Mohammed Shamseldin, Hendrik Heers, Thomas Steiner, Ralf Puls","doi":"10.1186/s42155-024-00475-1","DOIUrl":"10.1186/s42155-024-00475-1","url":null,"abstract":"<p><strong>Introduction: </strong>Ureterovascular fistula (UVF) is a rare but potentially life-threatening condition. Since its primary description by Moschkowitz in 1908, many case reports, studies and reviews have been written about this condition with the suggestive symptoms and risk factors repeatedly discussed. This study will be focusing on the different locations of 532 out of 605 fistulae published from 1908 up to 2022 besides eight new patients of our own.</p><p><strong>Material and methods: </strong>A systematic review of the literature started using PubMed database searching for \"ureteroarterial fistula\", \"arteriovascular fistula\" and \"uretero vascular fistula\" was performed yielding 122, 62 and 188 results respectively. Those studies and the cited literature in each study were examined to include studies, which did not appear in the primary search. A total of 605 patients in 315 publications were gathered. Only studies mentioning new patients, a clear indication of the location of the UVF, the presence/absence of urinary diversion (UD) as well as the type of UD if present were included. Ten duplicates as well as studies lacking information regarding the UVF and/or the UD (seven publications with 63 patients) were excluded, with 298 publications including 532 external patients remaining. Eight internal cases were included with a total of 540 cases.</p><p><strong>Results: </strong>From the 540 included cases, 384 patients (71.1%) had no UD compared to 156 patients (28.9%) with UD. Due to the anatomical ureteral course, the common iliac artery (CIA) was the most common vascular component of UVF, irrespective of the presence or absence of UD. Any dispute to whether the crossing point is the common or the external iliac artery (EIA) was settled for the CIA. Further common vascular components besides CIA include the aorta, EIA, internal iliac artery (IIA) including its branches and vascular bypasses including the anastomosis sites. Other unusual arterial localizations were stated under the \"others\" category.</p><p><strong>Conclusion: </strong>Identifying the location of the bleeding artery in UVF is critical and represents the most important step for successful management. We present the largest summary of described locations up to date including our own.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"63"},"PeriodicalIF":1.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective embolisation of an idiopathic bronchial artery pseudoaneurysm presenting with recurrent laryngeal nerve palsy: a case report.","authors":"R Copping, N Ng, S Osman","doi":"10.1186/s42155-024-00474-2","DOIUrl":"10.1186/s42155-024-00474-2","url":null,"abstract":"<p><strong>Background: </strong>Bronchial artery pseudoaneurysms (BAP) or aneurysms (BAA) are rare, potentially life-threatening and remain poorly understood. They are most commonly idiopathic but may be associated with a number of other disease processes. Bronchial artery embolisation (BAE) is considered the first line treatment while surgical techniques are reserved for patients with a clear contraindication to embolisation or where anatomical factors preclude an endovascular approach.</p><p><strong>Case presentation: </strong>We present an interesting case of a 56 year-old male presenting with an idiopathic unruptured right BAP causing clinical and radiological signs of left recurrent laryngeal nerve (RLN) palsy. He was otherwise clinically well with no other reported symptoms and no significant past medical history. There were no significant findings on work-up and investigation. He was ultimately treated successfully with selective transarterial coil embolization of the right bronchial artery. This is an atypical presentation of a rare clinical entity and has not previously been published in the literature to our knowledge.</p><p><strong>Conclusions: </strong>BAPs and BAAs are highly variable in their presentation, ranging from incidental asymptomatic findings to catastrophic haemorrhage, depending on their location and if they are contained or ruptured. Timely diagnosis and referral to facilitate urgent embolisation is essential to prevent potentially serious clinical sequelae. Endovascular treatment in the form of BAE is considered first line.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"62"},"PeriodicalIF":1.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional solutions for post-surgical problems: a lymphatic leaks review.","authors":"Fernando M Gómez, Tarik R Baetens, Ernestos Santos, Boris León Rocha, Benjamín Horwitz, Sara Lojo-Lendoiro, Patricio Vargas, Premal Patel, Regina Beets-Tan, José J Martínez-Rodrigo, Luis Martí Bonmatí","doi":"10.1186/s42155-024-00473-3","DOIUrl":"10.1186/s42155-024-00473-3","url":null,"abstract":"<p><p>The lymphatic circulation plays a crucial role in maintaining fluid balance and supporting immune responses by returning serum proteins and lipids to the systemic circulation. Lymphatic leaks, though rare, pose significant challenges post-radical neck surgery, oesophagectomy, and thoracic or retroperitoneal oncological resections, leading to heightened morbidity and mortality. Managing lymphatic leaks necessitates consideration of aetiology, severity, and volume of leakage. Traditionally, treatment involved conservative measures such as dietary restrictions, drainage, and medical management, with surgical intervention reserved for severe cases, albeit with variable outcomes and extended recovery periods. Lymphography, introduced in the 1950s, initially served as a diagnostic tool for lymphoedema, lymphoma, tumour staging, and monitoring chemotherapy response. However, its widespread adoption was impeded by alternative techniques like Computed Tomography, learning curves, and its associated complications. Contemporary lymphatic interventions have evolved, favouring nodal lymphangiography over pedal lymphangiography for its technical simplicity and reduced complexity. Effective management of chylous leaks mandates a multimodal approach encompassing clinical evaluation and imaging techniques. In cases where conservative management proves ineffective, embolization through conventional lymphangiography by bipedal dissection or intranodal injection emerges as a viable option. This review underscores the importance of a comprehensive approach to diagnosing and treating lymphatic leaks, highlighting advancements in imaging and therapeutic interventions that enhance patient outcomes.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"61"},"PeriodicalIF":1.2,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between statin intensity and femoropopliteal stent primary patency in peripheral arterial disease","authors":"Elisabeth R. Seyferth, Helen Song, Ansar Z. Vance, Timothy W. I. Clark","doi":"10.1186/s42155-024-00472-4","DOIUrl":"https://doi.org/10.1186/s42155-024-00472-4","url":null,"abstract":"Statins are widely used in coronary and peripheral arterial disease, but their impact on patency of stents placed for peripheral arterial disease is not well-studied. The purpose of this study was to evaluate femoropopliteal stent primary patency according to statin intensity at the time of stent placement and compare this effect to other covariates that may influence stent patency. A retrospective review identified 278 discrete femoropopliteal stent constructs placed in 216 patients over a 10-year period; Rutherford categories were 2 (3.6%), 3 (12.9%), 4 (21.2%), 5 (49.6%), and 6 (12.6%). Stent locations were common femoral (1.8%), common femoral/superficial femoral (0.7%), superficial femoral (50.7%), superficial femoral/popliteal (32.7%) and popliteal (14.0%) arteries; 63.3% of stents were paclitaxel-eluting. Primary patency of each stent construct was determined with duplex ultrasound, angiography, or computed tomographic angiography. Greater than 50% restenosis or stent occlusion was considered loss of patency. Cox proportional hazard and Kaplan–Meier modeling were used to assess the effect of statin use and additional covariates on stent patency. Patients on any statin at the time of stent placement were half as likely to undergo loss of primary unassisted patency as patients on no statin therapy (hazard ratio, 0.53; 95% confidence interval, 0.19–0.87; P = .004). Moderate/high intensity statin therapy conferred 17 additional months of median stent patency compared to the no statin group. Antiplatelet therapy, anticoagulant therapy, drug-eluting stents (versus bare metal or covered stents), and Rutherford class were not predictive of stent patency (P = 0.52, 0.85, 0.58, and 0.82, respectively). Use of statin therapy at the time of femoropopliteal stent placement was the most predictive examined variable influencing primary unassisted patency.","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"21 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141885012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trans-splenic percutaneous glue embolization of bleeding gastric varices in the setting of malignant sinistral portal hypertension","authors":"Ken Zhao, Sam Y. Son, Debkumar Sarkar, Ernesto G. Santos","doi":"10.1186/s42155-024-00467-1","DOIUrl":"https://doi.org/10.1186/s42155-024-00467-1","url":null,"abstract":"Sinistral portal hypertension, also known as left-sided portal hypertension, is a rare cause of gastric variceal bleeding which occurs secondary to occlusion of the splenic vein. We present a case of venous occlusion and sinistral portal hypertension secondary to distal pancreatic cancer requiring treatment of gastric variceal bleeding. After failing conservative management, transvenous intervention was attempted, but a venous communication with the gastric varices was unable to be identified on multiple venograms. A percutaneous trans-splenic approach using a 21-G needle and ultrasound guidance was successful in directly accessing an intraparenchymal vein feeding the gastric varices, and glue embolization was performed directly through the access needle with excellent results.","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"13 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141770901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine artery embolisation for adenomyosis in women who failed prior endometrial ablation","authors":"Eisen Liang, Razeen Parvez, Sylvia Ng, Bevan Brown","doi":"10.1186/s42155-024-00471-5","DOIUrl":"https://doi.org/10.1186/s42155-024-00471-5","url":null,"abstract":"<p>To report the effectiveness of uterine artery embolisation (UAE) in treating adenomyosis in women who failed prior endometrial ablation (EA).</p><p>Endometrial ablation (EA) is a minimally invasive treatment for heavy menstrual bleeding (HMB). Patient satisfaction rates for EA are around 80–90%; however, about 10–20% of women require additional intervention (re-ablation or hysterectomy) due to persistent bleeding or pain [1]. Women with adenomyosis are more likely to fail EA [2]. Those with unsatisfactory outcomes from EA may be offered hysterectomy as their only remaining treatment option. Case series and meta-analyses have demonstrated that UAE is effective in alleviating adenomyosis-related HMB and dysmenorrhea [3, 4]. However, the effectiveness of UAE in treating women who failed prior EA has not been previously reported. This is a retrospective cohort study of the outcome of UAE for adenomyosis in women who failed previous EA.</p><p>This study was approved by the institutional Human Research Ethics Committee. Informed consent was obtained from each participant. Women presenting to our clinic with significant dysmenorrhea and/or HMB following unsatisfactory endometrial ablation were offered UAE as an alternative to hysterectomy. Medical records of women who had UAE for adenomyosis at our institution between January 2017 and March 2022 were reviewed to identify those who had EA prior to UAE. All women had pre-UAE MRI to confirm the presence of adenomyosis, diagnosed based on previously published criteria: junctional zone thickness of ≥ 12 mm or &gt; 40% of myometrial thickness, or the presence of T2 hyperintense cysts/foci/fissuring [5]. All UAE procedures were performed with non-spherical polyvinyl alcohol (nsPVA) particles as previously described [4], and with starting nsPVA size at 180–300 micron (Cook 200) or 150–250 micron (Boston Scientific) as suggested by the 1-2-3 Protocol [6]. To evaluate the clinical outcome, a 2-part online survey was sent to women via email link to complete at home. Part 1 inquired about symptoms, menopausal status, overall satisfaction, and requirement for further intervention (Appendix 1). Women who had heavy menstrual bleeding prior to UAE were asked about their periods at the time of the audit. Overall success rate of UAE was assessed by asking women if they were “Very Satisfied,” “Satisfied,” “Not sure,” “Not Satisfied,” or “Very Unsatisfied” about the outcome. Only women who rated “Very Satisfied” or “Satisfied” were regarded as overall successful. Part 2 consisted of the validated Uterine Fibroid Symptom and Quality of Life Survey (UFSQoL) [7]. The following parameters before UAE and at follow-up were recorded and compared: dysmenorrhea visual analogue scale (VAS) pain score, number of days with dysmenorrhea, symptom score, and QoL score (using UFSQoL). Uterine volume and junctional zone thickness at baseline MRI and 6 months follow-up were compared. Significance of changes before and after treatment was","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"37 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141770902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome evaluation of prophylactic internal iliac balloon occlusion in the management of patients with placenta accreta spectrum.","authors":"Asaad Osman, Raj Das, Ana Pinas, Richard Hartopp, Deborah Livermore, Benjamin Hawthorn, Joo-Young Chun, Leto Mailli, Robert Morgan, Lakshmi Ratnam","doi":"10.1186/s42155-024-00466-2","DOIUrl":"10.1186/s42155-024-00466-2","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate outcomes and complications of prophylactic internal iliac balloon occlusion (PIIBO) in the management of patients with placenta accreta spectrum (PAS) at a large regional referral centre.</p><p><strong>Materials and methods: </strong>A retrospective review of all PIIBO for PAS performed over a 12-year period (2010-2022). Information for analysis was gathered from the local RIS/PACS and clinical documentation. Collected data included patient demographics, indication for procedure, sheath insertion and removal time, total duration of balloon inflation and complications that occurred.</p><p><strong>Results: </strong>106 patients underwent temporary internal iliac artery balloon occlusion within the 12-year period. All procedures utilised bilateral common femoral artery punctures, 6Fr sheath and 5Fr Le Maitre occlusion balloons. Catheters were successfully positioned and balloons inflated in obstetric theatre following caesarean delivery in 100% of the cases. The uterus was conserved in every case. There was no maternal mortality or foetal morbidity. Twenty patients (18.9%) had some form of complication that required further intervention. Of these, 7(6.6%) had post-operative PPH, which was treated with uterine artery embolisation; and 13 (12.3%) had arterial thrombus which required aspiration thrombectomy. All procedures were technically successful with no long-term sequelae.</p><p><strong>Conclusion: </strong>PIIBO plays an important part in reducing morbidity and mortality in patients with PAS. Clear pathways and multidisciplinary team working is critical in the management of these patients to ensure that any complications are dealt with promptly to avoid long-term sequelae.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"57"},"PeriodicalIF":1.2,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}