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European Radiology
Published in: European Radiology 12/2018

01-12-2018 | Vascular-Interventional

Prophylactic balloon occlusion of internal iliac arteries, common iliac arteries and infrarenal abdominal aorta in pregnancies complicated by placenta accreta: a retrospective cohort study

Authors: Kui Li, Yu Zou, Jin Sun, Hong Wen

Published in: European Radiology | Issue 12/2018

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Abstract

Objectives

To evaluate the efficacy of prophylactic balloon occlusion (PBO), and to compare haemostatic effects and perioperative outcomes of PBO of the internal iliac arteries (IIA), common iliac arteries (CIA) and infrarenal abdominal aorta (IAA) in patients with placenta accreta.

Methods

One hundred and ninety-nine patients with placenta accreta were retrospectively reviewed. One hundred and twelve cases who underwent PBO were allocated into PBO group, and 87 cases without endovascular intervention were classified as the control group. According to different methods, 112 patients in the PBO group were divided into IIA (n = 37), CIA (n = 42) and IAA (n = 33) subgroups.

Results

Patients in the PBO group had decreased estimated blood loss (EBL) and blood transfusion volume (BTV), as well as improved other perioperative outcomes. PBO (vs controls) could independently predict less EBL. As to comparison among subgroups, patients had decreased EBL and BTV, as well as improved other perioperative outcomes in CIA and IAA subgroups compared to the IIA subgroup. Further validation by multivariate analysis revealed that PBO of IIA (vs others) could independently predict more EBL.

Conclusions

PBO reduces intraoperative blood loss and improves other perioperative outcomes in patients with placenta accreta, and PBO of the CIA and IAA is more effective compared to PBO of IIA.

Key Points

• PBO of IIA, CIA and IAA is effective in placenta accreta.
• PBO of CIA and IAA is more effective.
• PBO could independently predict less EBL.
• Accreta depth was an independent risk factor for EBL.
Appendix
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Metadata
Title
Prophylactic balloon occlusion of internal iliac arteries, common iliac arteries and infrarenal abdominal aorta in pregnancies complicated by placenta accreta: a retrospective cohort study
Authors
Kui Li
Yu Zou
Jin Sun
Hong Wen
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5527-7

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