Coil embolization as a safe and effective treatment for a large uterine artery aneurysm in a gravid female

Figures

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  Fig. 1. (A-C) Ultrasound images of left adnexa showing an anechoic (1A), highly vascular structure with yin-yang appearance (1B) and turbulent internal flow (1C).

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  Fig. 2. (A-D) A large aneurysm in the left adnexa was identified on MRA (2A) and CTA (2B) at a bifurcation point without definite arteriovenous fistula, but apparent single arterial feeder on 4D Flow MRA (PC VIPR) arising of distal left uterine artery (2C-D).

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  Fig. 3. (A-C) Digital subtraction angiography images from left uterine arteriogram via right femoral approach demonstrates a large tortuous left uterine artery on early phase (3A) with filling of a large UAA (3B) as well as left uterine wall without early venous filling to suggest an arteriovenous fistula.

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  Fig. 4. Intraprocedural transabdominal color Doppler ultrasound of left adnexa showed partial thrombosis of the aneurysm sac with slower, but persistent inflow of aneurysm sac.

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  Fig. 5. (A-B) Post-embolization left uterine arteriogram (5A) showed filling of several uterine and lower cervical branches, but no opacification of the UAA or the left uterine fundus. This was confirmed with intra-procedural color Doppler ultrasound, which showed thrombosis of aneurysm sac and no further flow artifact.

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  Fig. 6. Axial CT angiography image at 6-month follow-up demonstrated persistent thrombosis of the left UAA sac without contrast enhancement and with slight interval decrease in size.