Evaluation of superselective arterial embolization in treating gestational trophoblastic tumors

Objective to evaluate superselective arterial embolization in treating gestational trophoblastic tumors.Methods From January 1999 to December 2009,superselective arterial embolization was carried out in 86 patients with gestational trophoblastic tumors.Of the 86 patients,34 presented with acute massive hemorrhage and 52 showed severe uterine ateriovenous fistula (AVF) on angiography.Systemic chemotherapy was performed in all patients.The therapeutic results were analyzed.Results After superselective arterial embolization the acute massive hemorrhage was successfully and immediately controlled in all 34 patients with bleeding (100%).Recurrence of bleeding occurred in two patients 3-5 days after the treatment,which was improved after repeated embolization therapy.Severe uterine ateriovenous fistula was observed in 52 cases,which disappeared on postoperative angiography.No severe bleeding occurred during the period of systemic chemotherapy.Eighty-four cases were able to be followed up.Seventy-nine patients (91.9%) survived so far.Complete remission was obtained in 71 (82.6%) and partial remission in 8 (9.3%) patients.Death occurred in five cases.Conclusion Superselective arterial embolization can effectively control and prevent severe hemorrhage from gestational trophoblastic tumors,which is very helpful for systemic chemotherapy.