PERCUTANEOUS ANGIOGRAPHIC ARTERIAL EMBOLIZATION FOR GYNECOLOGIC AND OBSTETRIC PELVIC HEMORRHAGE - A REPORT OF 3 CASES

Percutaneous angiographic arterial embolization for control of intract able hemorrage is being utilized increasingly in general surgery and t rauma patients. Recently there have been several reports on the applic ation of this technique in patients experiencing bleeding from the pel vic vasculature. We describe our management of three patients by percu taneous iliac aterial angiographic embolization. One patient, followin g repeat cesarean section for a twin gestation, developed intraabdomin al bleeding that failed to respond to classic maneuvers, including ces arean hysterectomy. A second patient suffered a deep vaginal sulcus te ar during spontaneous vaginal delivery. The third patient developed a hemorrhage from the vaginal cuff 31 days after vaginal hysterectomy. I n each case, angiography demonstrated extravasation of dye from a bran ch of the hypogastric artery. Selective embolization was uniformly suc cessful in quickly achieving hemostasis. There were no major complicat ions associated with the procedure.