1Dr. Kulsoom Fatima,1Shahmeer Khan, 1Shahmeer Khan, 1Dr. Raza Sayani, 1Dr. Tanveer Ul Haq, 1Dr. Tanveer Ul Haq, 2Dr. Ayesha Shoukat, 1Dr. Muhammad Sami Alam

1The Aga Khan University, 2Ziauddin University

Objective(s):

To review various types of uterine vascular malformations.

Overview of role of various imaging modalities including U/S, CT and MRI in workup of uterine vascular malformations.

To describe the role of digital subtraction angiography in differentiating true uterine arteriovenous malformations from other types of uterine vascular malformations.

To discuss Endovascular management of uterine vascular malformations.

Material(s) and Method(s):

Retrospective study conducted at department of radiology, Aga Khan university, which include 15 patients who presented for endovascular management of uterine vascular malformation identified on ultrasound, CT scan and MRI examination.

Result(s):

15 female patients mean age 28, 8 patients had isolated uterine hyperemia, hyperemia with tiny aneurysm n = 1, pseudoaneurysm n – 2, true AVM n = 3 and hypervascular fibroid = 1.Minor complications post intervention = 5, Major complication = 0
Parity Achieved in 8/15 with normal term delivery

Outcome of the malformation = Post procedure ultrasound showed resolution of the malformation on in 12 patients who underwent post procedure imaging, other 3 patient were doing clinically well with resolution of symptoms

Conclusion(s):

Acquired vascular malformation is a potentional cause of per vaginal bleeding with history of prior surgical intervention. Endovascular management is a superior option compared to hysterectomy with major advantage of preservation of chances of conception. Ultrasound is the first line screening imaging tool, with efficacy at detection of vascular malformation, however may not always be characterize the type of vascular malformation. CT and MRI can help in further evaluation. Digital subtraction angiography should be performed with intent is therapeutic. In our experience the expected success rate of trans arterial embolization is excellent with minimal chance of minor complications.