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Fig. 2 | BMC Pregnancy and Childbirth

Fig. 2

From: Role of collateral embolization in addition to uterine artery embolization followed by hysteroscopic curettage for the management of cesarean scar pregnancy

Fig. 2

Representative angiographic images of a 32-year-old female patient suffering from cesarean scar pregnancy undergoing embolization of >collateral supplying gestational sac (GS) in addition to uterine artery embolization. Angiography (a) of the left internal iliac artery (IIA) demonstrates the dilated left uterine artery (straight arrow) with typical tortuous trajectory and uterine perfusion, and a hypervascular gestational sac (dotted circle). Selective angiography (b) following microcatheterization of the left uterine artery (straight arrow) confirms the uterine perfusion and the hypervascular gestational sac (dotted circle). Angiography (c) of the left IIA performed after embolization of left uterine artery demonstrates the occlusion of left uterine artery and complete disappearance of uterine perfusion and hypervascularity enhancement in the GS region. Angiography (d) of the right IIA performed with ipsilateral anterior oblique projection (30°) demonstrates the dilated right uterine artery with typical tortuous trajectory and marked uterine perfusion. Selective angiography (e) following microcatheterization of the right uterine artery confirms the uterine perfusion. Angiography (f) of the right IIA performed after embolization of right uterine artery demonstrates the occlusion of right uterine artery, and the marked neovascularity and hypervascularity enhancement in the GS region (dotted circle). Selective angiography (g) following microcatheterization indicates the GS is supplied by a collateral (straight arrow) originating from the right internal pudendal artery (dotted arrow). The target collateral shows marked neovascularity and hypervascularity enhancement in the GS region (dotted circle). Angiography (h) of the right IIA performed after embolization of the target collateral demonstrates complete disappearance of hypervascularity enhancement in the GS region, without occlusion of the right internal pudendal artery (dotted arrow)

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