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Original Article

Pelvic arterial embolisation with cyanoacrylate during caesarean hysterectomy for placenta accreta

Kensaku Mori Department of Radiology, University of Tsukuba, Tsukuba, Japan Correspondencemoriken@md.tsukuba.ac.jp
ORCID Iconhttps://orcid.org/0000-0002-2599-0245ORCID Icon, Mana Obata-Yasuoka Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba, Japan , Tsukasa Saida Department of Radiology, University of Tsukuba, Tsukuba, Japan , Keiko Nishida Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba, Japan , Hiroaki Takahashi Department of Radiology, Mayo Clinic Rochester, Rochester, United States;, Yoshihiko Hosokawa Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba, Japan , Yohei Takei Department of Radiology, University of Tsukuba, Tsukuba, Japan , Ayako Tsumagari Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba, Japan , Miki Yoshida Department of Radiology, University of Tsukuba, Tsukuba, Japan , Yutaku Kimura Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba, Japan , Tetsuya Abe Department of Radiology, University of Tsukuba, Tsukuba, Japan , Yoko Tsukuda Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba, Japan , Shu Harada Department of Radiology, University of Tsukuba, Tsukuba, Japan , Takahiro Kojima Department of Urology, University of Tsukuba, Tsukuba, Japan & Manabu Minami Department of Radiology, University of Tsukuba, Tsukuba, Japan show all
Received 29 Nov 2019
Accepted 14 Aug 2020
Published online: 09 Sep 2020
 
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Abstract

Abstract

Purpose

To compare n-butyl cyanoacrylate (NBCA) and gelatine sponge (GS) as embolic materials for prophylactic pelvic arterial embolisation during caesarean hysterectomy for placenta accreta spectrum (PAS).

Material and methods

This retrospective study comprised 12 women (age range, 23–42 years; mean, 34.1 years) who underwent caesarean hysterectomy for PAS. Following caesarean delivery, bilateral uterine and non-uterine parasitic arteries were embolized with GS in the first four cases (GS group) and primarily with NBCA mixed with iodized oil in the subsequent eight cases (NBCA group). Procedure time for embolisation and hysterectomy and total blood loss were compared between the two groups using Welch’s t-test.

Results

Although procedure time for embolisation tended to be longer in the NBCA group than in the GS group (111 ± 47 min versus 71 ± 32 min, p=.11), that for hysterectomy was significantly reduced in the NBCA group when compared to the GS group (158 ± 42 min versus 236 ± 39 min, p=.02). Total blood loss was significantly lower in the NBCA group than in the GS group (1375 ± 565 mL versus 2668 ± 587 mL, p=.01).

Conclusion

Procedure time for hysterectomy and total blood loss during caesarean hysterectomy can be reduced by using NBCA instead of GS in prophylactic pelvic arterial embolisation for PAS.

Declaration of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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