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Embolization with gelatin foam in the management of vascularized retained products of conception: a multicenter study by the French Society of Cardiovascular Imaging.

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Title: Embolization with gelatin foam in the management of vascularized retained products of conception: a multicenter study by the French Society of Cardiovascular Imaging.
Authors: Ghelfi, Julien1,2 (AUTHOR) jghelfi@chu-grenoble.fr, Marcelin, Clément3 (AUTHOR), Buisson, Alexandre1,4 (AUTHOR), Mathieu, Eliott1,2 (AUTHOR), Sentilhes, Loic5 (AUTHOR), Thubert, Thibault6 (AUTHOR), Boizet, Antoine7 (AUTHOR), Midulla, Marco8 (AUTHOR), Kovacsik, Hélène9 (AUTHOR), Caudron, Sébastien10 (AUTHOR), Thouveny, Francine11 (AUTHOR), Barat, Maxime12 (AUTHOR), Frandon, Julien13 (AUTHOR), Barral, Pierre-Antoine14 (AUTHOR), Delouche, Aurélie1,2 (AUTHOR), David, Arthur15 (AUTHOR)
Source: European Radiology. May2025, Vol. 35 Issue 5, p2499-2507. 9p.
Subjects: Therapeutic embolization, Uterine hemorrhage, Disease risk factors, Safety, Treatment effectiveness, Embolisms, Gelatin
Abstract: Objectives: Vascularized retained products of conception (vRPOC) are the most frequent cause of delayed hemorrhage after abortion, spontaneous miscarriage, or delivery. This study evaluated the efficacy of uterine artery embolization (UAE) with gelatin foam in the management of symptomatic of vRPOC. Materials and methods: This retrospective study included patients who underwent UAE with gelatin foam for vRPOCs with vaginal bleeding between January 2018 and December 2022 in 11 French university hospitals. Embolization was performed using either gelatin foam torpedoes or sludge. The primary endpoint was the clinical success of embolization (cessation of bleeding at approximately 1 month after UAE). The secondary objectives were the success of imaging (no persistent vRPOC at imaging follow-up), the safety of UAE, and the predictive factors of clinical and imaging failure. Results: Two hundred twenty-four patients (median age, 30.5 years ± 5.7 [standard deviation]) were included. Clinical success was achieved in 212 patients (94.2%). One hundred sixty-five patients had imaging follow-ups, among whom 12 patients (7.3%) had persistent vascularization. According to the SIR classification, 30 patients (13.4%) had minor complications, and two patients (0.8%) had major complications (endometritis n = 1; ischemic uterine necrosis n = 1). No predictive factors of clinical success were found, but the presence of a hypertrophic uterine artery (OR = 0.6 [0.38–0.97], p = 0.045) and the use of gelatin foam torpedoes (OR = 0.57 [0.42–0.77], p = 0.0012) were associated with a greater risk of persistent vRPOC on imaging control. Conclusion: UAE with gelatin foam is safe and effective for treating hemorrhagic vRPOC. Key Points: QuestionUterine vacuity is frequently observed on ultrasound after UAE for vRPOC. FindingsA hypertrophic uterine artery and the use of gelatin foam torpedoes are associated with an increased risk of persistent vRPOC. Clinical relevanceEmbolization with gelatin foam is efficient and safe for treating bleeding in vRPOC. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Embolization with gelatin foam in the management of vascularized retained products of conception: a multicenter study by the French Society of Cardiovascular Imaging.
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  Data: <searchLink fieldCode="AR" term="%22Ghelfi%2C+Julien%22">Ghelfi, Julien</searchLink><relatesTo>1,2</relatesTo> (AUTHOR)<i> jghelfi@chu-grenoble.fr</i><br /><searchLink fieldCode="AR" term="%22Marcelin%2C+Clément%22">Marcelin, Clément</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Buisson%2C+Alexandre%22">Buisson, Alexandre</searchLink><relatesTo>1,4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mathieu%2C+Eliott%22">Mathieu, Eliott</searchLink><relatesTo>1,2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sentilhes%2C+Loic%22">Sentilhes, Loic</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Thubert%2C+Thibault%22">Thubert, Thibault</searchLink><relatesTo>6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Boizet%2C+Antoine%22">Boizet, Antoine</searchLink><relatesTo>7</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Midulla%2C+Marco%22">Midulla, Marco</searchLink><relatesTo>8</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kovacsik%2C+Hélène%22">Kovacsik, Hélène</searchLink><relatesTo>9</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Caudron%2C+Sébastien%22">Caudron, Sébastien</searchLink><relatesTo>10</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Thouveny%2C+Francine%22">Thouveny, Francine</searchLink><relatesTo>11</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Barat%2C+Maxime%22">Barat, Maxime</searchLink><relatesTo>12</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Frandon%2C+Julien%22">Frandon, Julien</searchLink><relatesTo>13</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Barral%2C+Pierre-Antoine%22">Barral, Pierre-Antoine</searchLink><relatesTo>14</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Delouche%2C+Aurélie%22">Delouche, Aurélie</searchLink><relatesTo>1,2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22David%2C+Arthur%22">David, Arthur</searchLink><relatesTo>15</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. May2025, Vol. 35 Issue 5, p2499-2507. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Therapeutic+embolization%22">Therapeutic embolization</searchLink><br /><searchLink fieldCode="DE" term="%22Uterine+hemorrhage%22">Uterine hemorrhage</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Safety%22">Safety</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Embolisms%22">Embolisms</searchLink><br /><searchLink fieldCode="DE" term="%22Gelatin%22">Gelatin</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objectives: Vascularized retained products of conception (vRPOC) are the most frequent cause of delayed hemorrhage after abortion, spontaneous miscarriage, or delivery. This study evaluated the efficacy of uterine artery embolization (UAE) with gelatin foam in the management of symptomatic of vRPOC. Materials and methods: This retrospective study included patients who underwent UAE with gelatin foam for vRPOCs with vaginal bleeding between January 2018 and December 2022 in 11 French university hospitals. Embolization was performed using either gelatin foam torpedoes or sludge. The primary endpoint was the clinical success of embolization (cessation of bleeding at approximately 1 month after UAE). The secondary objectives were the success of imaging (no persistent vRPOC at imaging follow-up), the safety of UAE, and the predictive factors of clinical and imaging failure. Results: Two hundred twenty-four patients (median age, 30.5 years ± 5.7 [standard deviation]) were included. Clinical success was achieved in 212 patients (94.2%). One hundred sixty-five patients had imaging follow-ups, among whom 12 patients (7.3%) had persistent vascularization. According to the SIR classification, 30 patients (13.4%) had minor complications, and two patients (0.8%) had major complications (endometritis n = 1; ischemic uterine necrosis n = 1). No predictive factors of clinical success were found, but the presence of a hypertrophic uterine artery (OR = 0.6 [0.38–0.97], p = 0.045) and the use of gelatin foam torpedoes (OR = 0.57 [0.42–0.77], p = 0.0012) were associated with a greater risk of persistent vRPOC on imaging control. Conclusion: UAE with gelatin foam is safe and effective for treating hemorrhagic vRPOC. Key Points: QuestionUterine vacuity is frequently observed on ultrasound after UAE for vRPOC. FindingsA hypertrophic uterine artery and the use of gelatin foam torpedoes are associated with an increased risk of persistent vRPOC. Clinical relevanceEmbolization with gelatin foam is efficient and safe for treating bleeding in vRPOC. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00330-024-11199-0
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        Text: English
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      – SubjectFull: Gelatin
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