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Classification of uterine artery angiographic images: a predictive factor of failure in uterine artery embolization for postpartum hemorrhage

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Abstract

Purpose

To justify a classification system for angiographic images of uterine artery embolization (UAE) for postpartum hemorrhage (PPH) and identify new risk factors associated with failed embolization.

Materials and methods

A retrospective analysis of 63 consecutive patients who underwent UAE for severe PPH was performed. Uterine artery angiography (UA) before embolization was classified into two types: type 1 was defined as complete staining and type 2 was defined as partial staining of the uterine arteries. The clinical outcome, UA classification, and other possible factors previously reported were evaluated. Univariate and multivariate analyses were performed to determine the factors related to clinical outcomes.

Results

Sixty-three patients were enrolled (type 1, 22; type 2, 41). The clinical success rates of the primary UAE session were 90.9% (20/22) for type 1 and 61.0% (25/41) for type 2 (p = 0.018). Univariate and multivariate analyses demonstrated that the only UA classification was significantly associated with primary UAE failure (p = 0.033).

Conclusions

The UA classification is an independent predictive factor of the clinical success rate of the primary UAE session for PPH; thus, it is an intuitive and optimal predictor for interventional radiologists to decide whether additional therapy is necessary.

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Funding

The authors have no fund for this research.

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Authors and Affiliations

  1. Center for Endovascular Therapy, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Eisuke Ueshima, Koji Sugimoto, Takuya Okada, Naoto Katayama & Masato Yamaguchi

  2. Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Eisuke Ueshima, Koji Sugimoto, Takuya Okada, Naoto Katayama, Yutaka Koide, Keitaro Sofue & Masato Yamaguchi

  3. Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Mayumi Morizane, Kenji Tanimura & Masashi Deguchi

Authors
  1. Eisuke Ueshima
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  2. Koji Sugimoto
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  3. Takuya Okada
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  4. Naoto Katayama
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  5. Yutaka Koide
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  6. Keitaro Sofue
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  7. Mayumi Morizane
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  8. Kenji Tanimura
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  9. Masashi Deguchi
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  10. Masato Yamaguchi
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Corresponding author

Correspondence to Eisuke Ueshima.

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Ethical approval

This study has been approved by Kobe University Research Ethics Committee.

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Ueshima, E., Sugimoto, K., Okada, T. et al. Classification of uterine artery angiographic images: a predictive factor of failure in uterine artery embolization for postpartum hemorrhage. Jpn J Radiol 36, 394–400 (2018). https://doi.org/10.1007/s11604-018-0736-1

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  • DOI: https://doi.org/10.1007/s11604-018-0736-1

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