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Successful Management of Giant Placental Chorangioma by Microcoil Embolization
Optimal prenatal management of giant placental chorangioma (also known as chorioangioma, angiomyxoma, fibroangiomyxoma, or fibroma) has yet to be determined. Interventions intended to devascularize the tumor such as interstitial laser, bipolar coagulation, fetoscopic laser photocoagulation, and chem...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Thieme Medical Publishers
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188883/ https://www.ncbi.nlm.nih.gov/pubmed/30345160 http://dx.doi.org/10.1055/s-0038-1669944 |
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author | Emery, Stephen P. Orons, Philip D. Bonadio, Jeffrey F. |
author_facet | Emery, Stephen P. Orons, Philip D. Bonadio, Jeffrey F. |
author_sort | Emery, Stephen P. |
collection | PubMed |
description | Optimal prenatal management of giant placental chorangioma (also known as chorioangioma, angiomyxoma, fibroangiomyxoma, or fibroma) has yet to be determined. Interventions intended to devascularize the tumor such as interstitial laser, bipolar coagulation, fetoscopic laser photocoagulation, and chemical embolization have met mixed results. We report a minimally invasive, extra-amniotic approach, technically similar to cordocentesis, of microcoil embolization of the feeding vessel. These percutaneously placed microcoils initiate clot formation at the site of insertion and are unable to migrate through the tumor, thereby minimizing fetal harm by downstream embolic phenomena. Intervention at 26 and 22 weeks resulted in intraoperative fetal loss in the former and vaginal delivery at term of a healthy neonate in the latter. Preoperative, intraoperative, and placental findings are highlighted. The ease and safety of this procedure may alter the risk–benefit equation toward earlier intervention with potentially better clinical outcomes. |
format | Online Article Text |
id | pubmed-6188883 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Thieme Medical Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-61888832018-10-19 Successful Management of Giant Placental Chorangioma by Microcoil Embolization Emery, Stephen P. Orons, Philip D. Bonadio, Jeffrey F. AJP Rep Optimal prenatal management of giant placental chorangioma (also known as chorioangioma, angiomyxoma, fibroangiomyxoma, or fibroma) has yet to be determined. Interventions intended to devascularize the tumor such as interstitial laser, bipolar coagulation, fetoscopic laser photocoagulation, and chemical embolization have met mixed results. We report a minimally invasive, extra-amniotic approach, technically similar to cordocentesis, of microcoil embolization of the feeding vessel. These percutaneously placed microcoils initiate clot formation at the site of insertion and are unable to migrate through the tumor, thereby minimizing fetal harm by downstream embolic phenomena. Intervention at 26 and 22 weeks resulted in intraoperative fetal loss in the former and vaginal delivery at term of a healthy neonate in the latter. Preoperative, intraoperative, and placental findings are highlighted. The ease and safety of this procedure may alter the risk–benefit equation toward earlier intervention with potentially better clinical outcomes. Thieme Medical Publishers 2018-10 2018-10-15 /pmc/articles/PMC6188883/ /pubmed/30345160 http://dx.doi.org/10.1055/s-0038-1669944 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Emery, Stephen P. Orons, Philip D. Bonadio, Jeffrey F. Successful Management of Giant Placental Chorangioma by Microcoil Embolization |
title | Successful Management of Giant Placental Chorangioma by Microcoil Embolization |
title_full | Successful Management of Giant Placental Chorangioma by Microcoil Embolization |
title_fullStr | Successful Management of Giant Placental Chorangioma by Microcoil Embolization |
title_full_unstemmed | Successful Management of Giant Placental Chorangioma by Microcoil Embolization |
title_short | Successful Management of Giant Placental Chorangioma by Microcoil Embolization |
title_sort | successful management of giant placental chorangioma by microcoil embolization |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188883/ https://www.ncbi.nlm.nih.gov/pubmed/30345160 http://dx.doi.org/10.1055/s-0038-1669944 |
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