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Retrograde Transvenous Obliteration for Uterine Arteriovenous Malformation

Kishino, Mitsuhiro MD; Miyasaka, Naoyuki MD; Takeguchi, Yuko MD; Ohashi, Isamu MD

doi: 10.1097/AOG.0000000000000083
Case Report

BACKGROUND: Transarterial embolization is an established treatment for uterine arteriovenous malformation (AVM); however, in some cases, transarterial embolization is difficult. We present balloon-occluded retrograde transvenous obliteration as an alternative endovascular treatment for uterine AVM.

CASE: A 24-year-old woman was diagnosed with uterine AVM. Her medical treatments were ineffective, and selective embolization was abandoned because of the extremely tortuous feeders. We used balloon-occluded retrograde transvenous obliteration, in which balloon catheters were inserted into the draining vein to stop the outflow. Then, a sclerosant was retrogradely injected through the catheter into the nidus. The abnormal vessels were fully obliterated, and there was no recurrence after the treatment.

CONCLUSION: Balloon-occluded retrograde transvenous obliteration may be an alternative treatment for uterine AVMs with adequate vascular structures.

Uterine arteriovenous malformation is successfully treated by balloon-occluded retrograde transvenous obliteration, which may be an alternative treatment to preserve reproductive potential.

Departments of Radiology and Pediatrics, Perinatal and Maternal Medicine, Tokyo Medical and Dental University, Tokyo, Japan.

Corresponding author: Naoyuki Miyasaka, MD, Department of Pediatrics, Perinatal and Maternal Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku Tokyo, Japan, 113-8519; e-mail: n.miyasaka.gyne@tmd.ac.jp.

Presented at the 42nd annual meeting of the Japanese Society of Interventional Radiology, May 16–18, 2013, Karuizawa Japan.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists.