Vascular complications following prophylactic balloon occlusion of the internal iliac arteries resolved by successful interventional thrombolysis in a patient with morbidly adherent placenta*

Autor: Weihua Lou, Yun-yan Chen, Zhi-guo Zhuang, Ning Zhang, Jia-ning Fu, Xuebin Zhang, Jian-hua Lin
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Adult
medicine.medical_specialty
Placenta accreta
medicine.medical_treatment
Placenta
Blood Loss
Surgical
Case Report
Placenta Accreta
Iliac Artery
General Biochemistry
Genetics and Molecular Biology
030218 nuclear medicine & medical imaging
Catheterization
03 medical and health sciences
0302 clinical medicine
Imaging
Three-Dimensional
Pregnancy
medicine.artery
Multidetector Computed Tomography
medicine
Humans
Thrombolytic Therapy
Vascular Diseases
General Pharmacology
Toxicology and Pharmaceutics
Thrombus
Blood Coagulation
Computed tomography angiography
030219 obstetrics & reproductive medicine
General Veterinary
medicine.diagnostic_test
business.industry
Cesarean Section
Balloon catheter
Angiography
Digital Subtraction
Sequela
Interventional radiology
General Medicine
Thrombolysis
Balloon Occlusion
medicine.disease
Internal iliac artery
Magnetic Resonance Imaging
Surgery
Female
Radiology
business
Popis: The increasing incidence of morbidly adherent placenta (MAP) is placing women at a higher risk of life-threatening massive hemorrhage. The involvement of interventional radiology to manage this complex condition by performing prophylactic iliac artery balloon occlusion has been reported recently. However, the effectiveness and safety of this technique have not been fully determined. Here we report the case of a 25-year-old woman with placenta increta with preemptive bilateral internal iliac artery balloons who had external iliac artery thrombosis detected by computed tomography angiography (CTA) 72 h post cesarean section. A digital subtraction angiogram (DSA) and intra-arterial thrombolysis were instantly performed followed by supplementary conservative treatments, leading to a desirable resolution of thrombus without sequela. This is the first report of vascular complications with successful interventional thrombolysis in this setting. Our experience suggests that prophylactic iliac artery balloon occlusion should be used cautiously in cases of MAP and consideration given to minimizing vascular complications given the hypercoagulable state of pregnancy.
Databáze: OpenAIRE
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