{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:20:17Z","timestamp":1755217217162,"version":"3.43.0"},"reference-count":14,"publisher":"Vilnius University Press","issue":"1","license":[{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AML"],"abstract":"<jats:p>Introduction:\u00a0Hemorrhage is one of the commonest and dreaded complications especially with pelvic surgeries. Gestational trophoblastic neoplasias (GTN) are notorious for their propensity to bleed torrentially and metastasis to vital organs. GTN is associated with an arterio-venous malformation (AVM) about 10-15% of the time, which can lead to bleeding after surgery or after complete remission. After the failure of conventional management with chemotherapy or surgery one is compelled to take another modality of management. One of such methods is the use of transcatheter artery embolization in cases of GTN or post-hysterectomy cases of GTN. Transcatheter artery\u00a0embolization (TAE) was effective in controlling bleeding due to arterio-venous malformation in 96% of cases.Case:\u00a046 years P2L2A5 (para 2, living issue 2, abortion 5) post-hysterectomy patient presented with bleeding from the vagina after surgery. Twice she underwent vaginal vault repair after hysterectomy but failed. Ultrasonography (USG) showed arterio-venous malformation (AVM); angiography revealed massive extravasation from (left internal iliac artery and abnormal vascularity from the right internal iliac. She was taken up for bilateral internal iliac arteries embolization but again had a heavy bout of bleeding after one week. CT scan confirmed a residual lesion and she underwent a repeat embolization after which the bleeding stopped. Serum BHCG was advised during workup and it was 1997 IU\/ml. A diagnosis of GTN was confirmed. The patient was discharged after two cycles of chemotherapy with advice to review for the third one on an outpatient department basis.Conclusion:\u00a0We concluded that TAE is an effective and safer alternative to surgery in postoperative bleeding from AV malformation in the case of GTN. It can be repeated and should be made to more liberal use in emergency settings.<\/jats:p>","DOI":"10.15388\/amed.2021.28.1.11","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:47:01Z","timestamp":1615250821000},"page":"159-164","source":"Crossref","is-referenced-by-count":1,"title":["Transcatheter Artery Embolization for Postoperative Haemorrhage after Arterio-Venous Malformation \u2013 Safer Option"],"prefix":"10.15388","volume":"28","author":[{"given":"Panda","family":"Subrat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharma","family":"Nalini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khan Dina","family":"Aisha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saha","family":"Anusmita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Das","family":"Rituparna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phukan","family":"Pranjal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6097","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"doi-asserted-by":"publisher","unstructured":"Panda S, Sharma N, Phukan P. Repeated broad ligament hematomas managed by uterine artery embolization: time to execute Int J Reprod Contracept Obstet Gynecol. 2019;8(8):3417-3421. http:\/\/dx.doi.org\/10.18203\/2320-1770.ijrcog20193578.","key":"ref0","DOI":"10.18203\/2320-1770.ijrcog20193578"},{"doi-asserted-by":"publisher","unstructured":"Vedantham S, Goodwin SC, McLucas B, Mohr G. Uterine artery embolization: an underused method of controlling pelvic hemorrhage. Am J Obstet Gynecol. 1997;176:938 -948.doi: 10.1016\/s0002-9378(97)70624-0.","key":"ref1","DOI":"10.1016\/S0002-9378(97)70624-0"},{"doi-asserted-by":"publisher","unstructured":"ZA Shawky Badawy, A Etman A, Singh M et al . Uterine artery embolization The role in obstetrics and gynecology Journal of Clinical Imaging. 2001 ;25(4):288 - 95 DOI: 10.1016\/S0899-7071(01)00307-2.","key":"ref2","DOI":"10.1016\/S0899-7071(01)00307-2"},{"doi-asserted-by":"publisher","unstructured":"saxena A, Jain ME. Endovascular Management of a rare case of pelvic haemorrhage. JCR.2019;9:152-156. http:\/\/dx.doi.org\/10.17659\/01.2019.0040.","key":"ref3","DOI":"10.17659\/01.2019.0040"},{"doi-asserted-by":"publisher","unstructured":"AK Lim , Agarwal R., MJSeck. Et al Embolization of bleeding residual uterine Uterine Vascular Malformations in Patients with Treated Gestational Trophoblastic Tumors. Vascular and Interventional Radiology.2002;222(3) https:\/\/doi.org\/10.1148\/radiol.2223010035.","key":"ref4","DOI":"10.1148\/radiol.2223010035"},{"doi-asserted-by":"publisher","unstructured":"Kyung JinEoh Young Shin Chung, Ga Won Yim et al . Role of surgical therapy in the management of gestational trophoblastic neoplasia. Obstetrics & Gynecology Science; 2015;58(4):277-283. doi: 10.5468\/ogs.2015.58.4.277.","key":"ref5","DOI":"10.5468\/ogs.2015.58.4.277"},{"doi-asserted-by":"publisher","unstructured":"Marian Lobo R, Taha M, Jeremy Herod J, et al. Management of acute haemorrhage following chemotherapy for invasive molar pregnancy by embolization and conservative fertility-sparing surgery. Gynecologic Oncology Reports. 2020;32:100556 doi: 10.1016\/j.gore.2020.100556.","key":"ref6","DOI":"10.1016\/j.gore.2020.100556"},{"doi-asserted-by":"publisher","unstructured":"Method MW, Hirschfield M, Everette HE. Angiographic-guided embolization of metastatic invasive mole. Gynecol Oncol 1996;61:442e5. DOI: 10.1006\/gyno.1996.0171.","key":"ref7","DOI":"10.1006\/gyno.1996.0171"},{"unstructured":"Keepanasseril A, Suri V, Prasad GRV et al. Management of massive hemorrhage in patients with gestational trophoblastic neoplasia by angiographic embolization: a safer alternative. J Reprod Med. 2011;56(5-6):235-40. PMID: 21682119.","key":"ref8"},{"doi-asserted-by":"publisher","unstructured":"Z. Wang Li X, Pan J et al. Bleeding from gestational trophoblastic neoplasia: embolotherapy efficacy and tumour response to chemotherapy\/ Clinical Radiology. 2017;72: 992. DOI:http:\/\/doi.org.\/10.1016\/j.crad.2017.06.004.","key":"ref9","DOI":"10.1016\/j.crad.2017.06.004"},{"doi-asserted-by":"publisher","unstructured":"Carlini L, Villa A, Busci L, et al. Selective uterine artery embolization: a new therapeutic approach in a patient with low-risk gestational trophoblastic disease. Am J Obstet Gynecol 2006;195:314e5. doi: 10.1016\/j.ajog.2006.02.029.","key":"ref10","DOI":"10.1016\/j.ajog.2006.02.029"},{"doi-asserted-by":"publisher","unstructured":"Maleux G, Timmerman D, Heye S, et al. Acquired uterine vascular malformations: radiological and clinical outcome after transcatheter embolotherapy. Eur Radiol 2006;16:299e306. DOI: 10.1007\/s00330-005-2799-5.","key":"ref11","DOI":"10.1007\/s00330-005-2799-5"},{"doi-asserted-by":"publisher","unstructured":"Jacques L, Lund M and Baruah D. Uterine Arteriovenous Malformations: A Rare Cause of Vaginal Hemorrhage after Hysterectomy. Gynecol Obstet Case Rep. 2016; 2:2. doi:10.21767\/2471-8165.1000029.","key":"ref12","DOI":"10.21767\/2471-8165.1000029"},{"doi-asserted-by":"publisher","unstructured":"Robert L. Vogelzang, Albert A. Nemcek, Zeke Skrtic, Jan Gorrell, John R. Lurain. Uterine Arteriovenous Malformations: Primary Treatment with Therapeutic Embolization. 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