Application of Uterine Artery Embolization in Patients With Placenta Accreta Spectrum After Abdominal Aortic Balloon Occlusion

Vasc Endovascular Surg. 2024 Jul;58(5):498-504. doi: 10.1177/15385744241229596. Epub 2024 Jan 22.

Abstract

Objective: To evaluate the application of different uterine artery embolization procedures under balloon occlusion of the abdominal aorta in patients with Placenta Accreta Spectrum (PAS) undergoing cesarean section.

Materials and methods: A retrospective analysis was performed on clinical data from 72 patients who underwent uterine artery embolization for hemostasis during cesarean section with PAS. The patients were divided into two groups according to the embolization method used during surgery: group A (n = 43) underwent uterine artery embolization by withdrawing the balloon and inserting a Cobra catheter into the uterine artery for embolization, while group B (n = 29) underwent uterine artery embolization with a Cobra catheter inserted via contralateral puncture of the femoral artery and balloon occlusion. General information, surgical data, and postoperative recovery were compared between the 2 groups.

Results: The bleeding and transfusion volumes were lower in group B than in group A and the differences between the 2 groups were statistically significant. There were no significant differences in surgical duration, number of embolized vessels, length of hospital stay, postoperative complications, or menstrual recovery between the 2 groups.

Conclusion: For patients with PAS undergoing cesarean section, uterine artery embolization for hemostasis is preferably performed by inserting a Cobra catheter via contralateral puncture of the femoral artery under abdominal aortic balloon occlusion.

Keywords: balloon occlusion; blood loss; embolization; placenta accreta.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aorta, Abdominal* / diagnostic imaging
  • Balloon Occlusion* / adverse effects
  • Blood Loss, Surgical / prevention & control
  • Blood Transfusion
  • Catheterization, Peripheral / adverse effects
  • Cesarean Section* / adverse effects
  • Female
  • Femoral Artery / diagnostic imaging
  • Humans
  • Placenta Accreta* / diagnostic imaging
  • Placenta Accreta* / therapy
  • Postpartum Hemorrhage* / etiology
  • Postpartum Hemorrhage* / therapy
  • Pregnancy
  • Punctures
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Uterine Artery Embolization* / adverse effects