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. 2007 Sep;24(3):296-9.
doi: 10.1055/s-2007-985737.

Embolization of a traumatic uterine arteriovenous malformation

Monette S Castillo  1 , Marc A Borge, Kenneth L Pierce
Affiliations

Embolization of a traumatic uterine arteriovenous malformation

Monette S Castillo et al. Semin Intervent Radiol. 2007 Sep.

Abstract

Uterine arteriovenous malformation (AVM) is a rare but potentially life-threatening source of bleeding. A high index of suspicion and accurate diagnosis of the condition in a timely manor are essential because instrumentation that is often used for other sources of uterine bleeding can lead to massive hemorrhage. Although angiography remains the gold standard for diagnosis, ultrasound (US) and magnetic resonance imaging (MRI) are the modalities of choice for the evaluation of a suspected AVM. US and MRI cannot only accurately define a uterine AVM, but they also have the ability to assess the extent of pelvic involvement noninvasively. The definitive treatment of uterine AVM is hysterectomy. However, most women diagnosed with the condition are of childbearing age. Transcatheter uterine artery embolization offers a safe and effective alternative to surgery, with the major advantage of retaining childbearing capacity.

Keywords: Uterine artery embolization; uterine arteriovenous malformation.

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Figures

Figure 1
Figure 1
Ultrasound (US) and magnetic resonance imaging (MRI) features of a traumatic uterine arteriovenous malformation in a 29-year-old woman. (A) Transvaginal color and spectral Doppler US demonstrates increased vascularity of the endometrium and high velocities, indicating low resistance within the vascular structure. (B) and (C) Axial T1-weighted MRI pre- and postcontrast show a bulky mass containing multiple flow-related signal voids extending from the uterine cavity to the myometrium. There is avid enhancement of the vascular structure with gadolinium.
Figure 2
Figure 2
Embolization of the traumatic uterine arteriovenous malformation. (A) Initial pelvic arteriogram reveals a tangle of vessels projected in the region of the uterus fed primarily by the left uterine artery. (B) and (C) Selective uterine artery injection shows a tortuous vascular mass supplied by the left uterine artery and early venous filling during the late arterial phase. Note that there is filling of the superior vesical artery in (B).
See this image and copyright information in PMC

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