Milena Coppola1, Francesco Giurazza2, Fabio Corvino2, Francesco Pane3, Mattia Silvestre2, Raffaella Niola2. 1. Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy. millicop@gmail.com. 2. Department of Vascular and Interventional Radiology, Cardarelli Hospital, Naples, Italy. 3. Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
Abstract
PURPOSE: Interventional radiology plays an established role in the management of many conditions of the female reproductive tract. Since in benign gynecological and obstetric pathologies, as myomas and postpartum hemorrhages, uterine arteries embolization has been already evaluated, this manuscript aims to report on a single-center experience concerning the endovascular management of metrorrhagia caused by gynecological malignancies. MATERIALS AND METHODS: Single-center retrospective analysis of thirty patients affected by gynecologic cancer treated with endovascular embolization between January 2016 and December 2018 for acute or chronic metrorrhagia. RESULTS: All patients were in advanced oncological stage (III or IV) with loco-regional spread of the tumor or invasion of pelvic structures, with a poor performance status. They were not suitable for surgery. On initial CT angiography, contrast media extravasation was confirmed in two patients (6.6%), while on DSA examination, tumor stain was displayed in 28 patients (93.4%). In two patients (6.6%) a pseudoaneurysm was reported. CONCLUSIONS: Endovascular treatment of metrorrhagia in oncologic patients could be a valid therapeutic alternative, especially when in elderly patients with poor clinical conditions not suitable for surgery. A bilateral and superselective embolization using non-resorbable embolic agents should be performed, except for those cases in which there is infiltration of major vessels causing pseudoaneurysms or fistulas that require embolization.
PURPOSE: Interventional radiology plays an established role in the management of many conditions of the female reproductive tract. Since in benign gynecological and obstetric pathologies, as myomas and postpartum hemorrhages, uterine arteries embolization has been already evaluated, this manuscript aims to report on a single-center experience concerning the endovascular management of metrorrhagia caused by gynecological malignancies. MATERIALS AND METHODS: Single-center retrospective analysis of thirty patients affected by gynecologic cancer treated with endovascular embolization between January 2016 and December 2018 for acute or chronic metrorrhagia. RESULTS: All patients were in advanced oncological stage (III or IV) with loco-regional spread of the tumor or invasion of pelvic structures, with a poor performance status. They were not suitable for surgery. On initial CT angiography, contrast media extravasation was confirmed in two patients (6.6%), while on DSA examination, tumor stain was displayed in 28 patients (93.4%). In two patients (6.6%) a pseudoaneurysm was reported. CONCLUSIONS: Endovascular treatment of metrorrhagia in oncologic patients could be a valid therapeutic alternative, especially when in elderly patients with poor clinical conditions not suitable for surgery. A bilateral and superselective embolization using non-resorbable embolic agents should be performed, except for those cases in which there is infiltration of major vessels causing pseudoaneurysms or fistulas that require embolization.
Authors: Fabio Corvino; Francesco Giurazza; Gianluca Cangiano; Mattia Silvestre; Enrico Cavaglià; Giuseppe de Magistris; Francesco Amodio; Antonio Corvino; Raffaella Niola Journal: Ann Vasc Surg Date: 2019-02-04 Impact factor: 1.466
Authors: Michael D Katz; Sebastian B Sugay; Daphne K Walker; Suzanne L Palmer; M Victoria Marx Journal: Radiographics Date: 2012-10 Impact factor: 5.333