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| Vascular complications following prophylactic balloon occlusion of the internal iliac arteries resolved by successful interventional thrombolysis in a patient with morbidly adherent placenta |
| Ning Zhang, Wei-hua Lou, Xue-bin Zhang, Jia-ning Fu, Yun-yan Chen, Zhi-guo Zhuang, Jian-hua Lin |
| Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200126, China; Department of Interventional Oncolog, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200126, China; Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY 10032, USA; Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200126, China |
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Abstract The increasing incidence of morbidly adherent placenta (MAP) is placing women at a higher risk of life-threatening massive hemorrhage. The involvement of interventional radiology to manage this complex condition by performing prophylactic iliac artery balloon occlusion has been reported recently. However, the effectiveness and safety of this technique have not been fully determined. Here we report the case of a 25-year-old woman with placenta increta with preemptive bilateral internal iliac artery balloons who had external iliac artery thrombosis detected by computed tomography angiography (CTA) 72 h post cesarean section. A digital subtraction angiogram (DSA) and intra-arterial thrombolysis were instantly performed followed by supplementary conservative treatments, leading to a desirable resolution of thrombus without sequela. This is the first report of vascular complications with successful interventional thrombolysis in this setting. Our experience suggests that prophylactic iliac artery balloon occlusion should be used cautiously in cases of MAP and consideration given to minimizing vascular complications given the hypercoagulable state of pregnancy.
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Received: 09 July 2016
Published: 08 March 2017
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