Uterine Vascular Malformations and Embolization Techniques

Uterine vascular malformations encompass a spectrum of abnormal blood vessel formations within the uterine wall, most notably arteriovenous malformations (AVMs) and pseudoaneurysms. These lesions often present with life-threatening haemorrhage or persistent bleeding following pregnancy-related events or uterine instrumentation. Accurate diagnosis relies on high-resolution ultrasound with colour and pulsed-wave Doppler to characterise flow patterns, supplemented by magnetic resonance imaging in complex cases. Minimally invasive embolization techniques have transformed management by selectively occluding pathological vessels while preserving uterine function. Embolic materials range from temporary agents such as gelatin sponge to permanent devices including coils and liquid polymers, chosen according to flow dynamics and fertility goals. A multidisciplinary approach integrates radiological expertise, gynaecological assessment and patient-centred counselling, enabling individualised treatment strategies that balance haemostatic efficacy with future pregnancy aspirations. Ongoing refinements in catheter technology, three-dimensional imaging guidance and embolic chemistry continue to improve safety profiles and long-term outcomes, underscoring the global importance of embolization as a fertility-sparing therapy for uterine vascular lesions.

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Uterine Vascular Malformations and Embolization Techniques publication trend

The graph below shows the total number of articles in uterine vascular malformations and embolization techniques across all publications each year (not limited to Nature Index journals).

Technical terms

Uterine arteriovenous malformation: A pathological shunt between uterine arteries and veins bypassing capillaries, resulting in high-flow vascular channels.

Uterine artery embolisation: A radiological procedure that selectively occludes uterine blood vessels using embolic agents to control bleeding or reduce lesion vascularity.

Peak systolic velocity (PSV): The maximum blood flow speed measured during cardiac systole by Doppler ultrasound, indicative of lesion flow intensity.

Resistance index (RI): A Doppler ultrasound parameter calculated as (PSV – end-diastolic velocity)/PSV, reflecting downstream vascular resistance.

Embolic agent: A substance (e.g. gelatin sponge, coils, liquid polymers) introduced into the vasculature to induce vessel occlusion.

Pseudoaneurysm: A contained arterial wall rupture forming a blood-filled cavity that communicates with the parent artery, prone to rupture if untreated.

References

1. Uterine Arteriovenous Malformation: Diagnostic and Therapeutic Challenges. Diagnostics (2024).
2. The efficacy of uterine artery embolization with gelatin sponge for retained products of conception with bleeding and future pregnancy outcomes. CVIR Endovascular (2020).
3. Uterine Artery Embolization of Uterine Arteriovenous Malformation: A Systematic Review of Success Rate, Complications, and Posterior Pregnancy Outcomes. Journal of Personalized Medicine (2022).