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

Vascular and endovascular surgery Pub Date : 2024-07-01 Epub Date: 2024-01-22 DOI:10.1177/15385744241229596
Kai Zhang, Shuqin Cheng, Yunxiao Zhi, Lin Lu, Mingsheng Yi, Shihong Cui
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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.

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子宫动脉栓塞术在腹主动脉球囊闭塞后胎盘早剥患者中的应用
目的评估在腹主动脉球囊闭塞的情况下,不同子宫动脉栓塞术在接受剖宫产术的无子宫前置胎盘(PAS)患者中的应用:对 72 例在剖宫产术中接受子宫动脉栓塞止血术的 PAS 患者的临床数据进行了回顾性分析。根据手术中使用的栓塞方法将患者分为两组:A 组(n = 43)通过抽出球囊并将 Cobra 导管插入子宫动脉进行栓塞,而 B 组(n = 29)通过对侧穿刺股动脉并用球囊闭塞插入 Cobra 导管进行子宫动脉栓塞。比较了两组患者的一般信息、手术数据和术后恢复情况:结果:B组的出血量和输血量均低于A组,两组间差异有统计学意义。两组在手术时间、栓塞血管数量、住院时间、术后并发症和月经恢复方面无明显差异:结论:对于接受剖宫产术的 PAS 患者,最好在腹主动脉球囊闭塞的情况下,通过对侧穿刺股动脉插入眼镜蛇导管,进行子宫动脉栓塞止血。
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