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The Use of Interventional Endovascular Techniques Immediately Before Hysterectomy for a Large Uterine Arteriovenous Malformation

Abstract Background: Interventional radiologic techniques can be used to aid in the management of complex obstetric and gynecological disorders such as postpartum hemorrhage, fibroids, placenta accreta/percreta, arteriovenous malformations (AVMs) and other disorders associated with morbidity and mortality. Case: A 36-year-old female, with a history of 2 second-trimester spontaneous abortions, presented for surgical evaluation for a planned hysterectomy after pelvic magnetic resonance imaging showed a significant uterine AVM. Due to concern about hemorrhage during the surgery, bilateral iliac and bilateral ovarian arterial balloon catheters were placed intra-arterially, under fluoroscopic guidance, prior to surgery. After placement of the balloon catheters, with the patient under conscious sedation, she was transferred to the operating room and given general anesthesia. Diagnostic hysteroscopy showed that she had intrauterine scarring consistent with prior dilations and curettages. The balloons were inflat...