To understand the various indications, techniques and embolic materials involved in transcatheter management of various obstetric & gynaecologic (O&G) conditions.
To appreciate the angiographic appearancesduring thetreatment of these conditions.
The innovation of transcatheter intervention allows for minimally invasive procedure to tackle life threatening O&G conditions and thereby avoiding major surgeries. Embolisation procedures are performed for haemostasis, shrinking of tumoural mass or obliteration of an abnormal vasculature. Sometimes, when temporary operative bleeding control is required, balloon occlusion devices can be employed. The most commonly performed procedure is uterine artery embolization for treatment of uterine fibroids but clinical indications are broader now, encompassing notably various obstetric emergencies and even palliative management in cases of gynaecological cancers....
Findings and procedure details
Sheaths, Angiographic Catheters, Guidewires & Embolic Materials
Access sheaths: standard 5Fr or 6Fr sheath are used for co-axial access site. 6Fr are usually needed when balloon occlusion device is anticipated.
Angiographic catheters: 4Fr or 5Fr Cobra C1, Simmons 1 & pigtail. Microcatheter system such as 2.6Fr Progreat TERUMOTM or 1.8Fr Carnelian TOKAITM
Guidewires: 0.035” hydrophilic floppy tip wire TERUMOTM, 0.014” hydrophilic shapable tip microwire TRANSENDTM
Embolic Agents: Gelfoam slurry, Polyvinyl alcohol (PVA) particles (300-500um), Pushable Platinum Coils, Glue-Lipiodol emulsion.
Angioplasty Balloons: Compliant angioplasty balloon such...
There are wide range of O&G conditions which can be managed by interventional radiologists via endovascular approach, which will undoubtedly be more commonplace in future radiology practice. Good understanding of the clinical indications, techniques and procedural details is thus relevant to the present and future radiology trainees.
Personal information and conflict of interest
Dr Strahan Teoh
Department of Radiology,
Sarawak General Hospital
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