Osman, A; Das, R; Pinas, A; Hartopp, R; Livermore, D; Hawthorn, B; Chun, J-Y; Mailli, L; Morgan, R; Ratnam, L
(2024)
Outcome evaluation of prophylactic internal iliac balloon occlusion in the management of patients with placenta accreta spectrum.
CVIR Endovasc, 7 (1).
p. 57.
ISSN 2520-8934
https://doi.org/10.1186/s42155-024-00466-2
SGUL Authors: Morgan, Robert Anthony
Abstract
PURPOSE: To evaluate outcomes and complications of prophylactic internal iliac balloon occlusion (PIIBO) in the management of patients with placenta accreta spectrum (PAS) at a large regional referral centre. MATERIALS AND METHODS: A retrospective review of all PIIBO for PAS performed over a 12-year period (2010-2022). Information for analysis was gathered from the local RIS/PACS and clinical documentation. Collected data included patient demographics, indication for procedure, sheath insertion and removal time, total duration of balloon inflation and complications that occurred. RESULTS: 106 patients underwent temporary internal iliac artery balloon occlusion within the 12-year period. All procedures utilised bilateral common femoral artery punctures, 6Fr sheath and 5Fr Le Maitre occlusion balloons. Catheters were successfully positioned and balloons inflated in obstetric theatre following caesarean delivery in 100% of the cases. The uterus was conserved in every case. There was no maternal mortality or foetal morbidity. Twenty patients (18.9%) had some form of complication that required further intervention. Of these, 7(6.6%) had post-operative PPH, which was treated with uterine artery embolisation; and 13 (12.3%) had arterial thrombus which required aspiration thrombectomy. All procedures were technically successful with no long-term sequelae. CONCLUSION: PIIBO plays an important part in reducing morbidity and mortality in patients with PAS. Clear pathways and multidisciplinary team working is critical in the management of these patients to ensure that any complications are dealt with promptly to avoid long-term sequelae.
Item Type: |
Article
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Additional Information: |
© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ |
Keywords: |
Interventional radiology, Placenta accreta spectrum, Postpartum haemorrhage, Prophylactic occlusion balloon, Uterine artery embolisation, Vascular complication, Interventional radiology, Placenta accreta spectrum, Postpartum haemorrhage, Prophylactic occlusion balloon, Uterine artery embolisation, Vascular complication |
SGUL Research Institute / Research Centre: |
TACRI |
Journal or Publication Title: |
CVIR Endovasc |
ISSN: |
2520-8934 |
Language: |
eng |
Dates: |
Date | Event |
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23 July 2024 | Published | 24 June 2024 | Accepted |
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Publisher License: |
Creative Commons: Attribution 4.0 |
PubMed ID: |
39039376 |
Web of Science ID: |
WOS:001274061300001 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/116788 |
Publisher's version: |
https://doi.org/10.1186/s42155-024-00466-2 |
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